The World-Changing Science of Organ Manufacturing w/ Dean Kamen | EP #100

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On at the level of science. It's clear that the science has gotten way ahead of the manufacturing when it comes to cells, tissues and organs. If any of you know, somebody waiting for a transplant of any kind of organ, even hearts in particular, it's a long, terrifying wait for a typical adult. Think about a baby or a small child that needs one of these organs. You really want some other baby or small child to have to die? We shouldn't have to wait for people to die in order to let somebody live. We got to stop this. There's no equivalent of Silicon Valley that will bring the engineering community, the manufacturing community to the world of science. We're going to make it practical to manufacture high quantity, high quality, reasonable price cells, tissues and organs.

Let's actually begin the story of these eyebots and then I want to get into some of the extraordinary moonshots you're in the midst of.

So a long time ago in a faraway place, we decided that a wheelchair, which has been the Standard of care since actually, Benjamin Franklin, another inventor, bifocals, other medical inventions. Ben Franklin, 200 years ago, patented a wheelchair. He should have been proud of it. After 200 years, we can build machines that go to the moon, go to planets. We have machines that could put people everywhere under the sea. But until I started building this standard of care for people that couldn't walk, it's a wheelchair. If any of you have ever had to use one, even for a day or a week, you'll know what a pathetic alternative that is. And it's not just about mobility. And I knew that when we started building these things. When somebody is confined to a wheelchair, and by the way, confined is a common phrase for that, the only other place I always hear the word confined is if somebody is so evil, we confine them to prison. I don't think a vet that comes back from leaving his legs in Afghanistan on an IED should be confined to a wheelchair. And I realized since I built helicopters and autopilots and all sorts of things, why don't we take solid state gyros and accelerometers and high performance control systems and build something that simulates human balance. Everybody in this room has a mom that remembers two things about you as a little kid. Your first words and your first steps. They're uniquely human. We walk erect. And when somebody loses the ability for any reason, disease, accidents, when you lose the ability to stand up, it's not about mobility. Yes, this thing climbs curbs and stairs and goes through sand. We'll show you a video of that. But. But you don't spend much of your day climbing stairs. But you spend most of your time interfacing with your colleagues, your family, your husband, your wife, your kids. And to do that from a confined position, you didn't lose mobility. You lost dignity, you lost access, you lost independence. So we decided we'll fix that. And we did. We took it to the fda. Yeah, we took it to the FDA and they said, you know, we approve products based on benefit and risk. You know, you got glioblastoma. We know what the outcome's going to be. We'll try anything. And they approve drugs that have three pages of small print about what it might do to you, but the risk and benefit are there. We took this to the FDA and they said, we won't even accept a proposal to review that thing because wheelchairs are safe and there's no benefit. I had to convince people at the FDA they ought to try living in a wheelchair for a while. We ended up compromising and doing it my way.

We know that theme song here.

We submitted it. I pointed out it would be triply redundant. No single failure of a component, a system, a power supply, a processor, a gyroscope. There's multiples of them. I said, we will not build a system that any single point failure will bring this thing down. We put some out there. And after the fleet collected slightly over 10 million hours of operation in the field with real people, not a single system had ever gone down. We went back to the FDA and said, we want to take us out of class three, put us back into class two so we can start making units for pediatric patients and for others probably in the history, as I know, of the FDA moving down a category from the most severe class three into class two based on data. We got that change, we got this thing into Class 2. We built a new generation of them. We just recently, in January, after only 16 years, got CMS, Medicare, and Medicaid to say yes. We recognize that there's a need for this and they're putting it on their list. The Veterans Administration. The Veterans administration has accepted 50 of them. I donated two to each of the 25 VA hospitals that take care of our vets. And I hope they're going to start letting vets have a better quality of life. We have a, I think a one minute video that shows this thing running around if you want to see.

Well, I want to. So this is amazing. As is your Luke arm, as is your slingshot, as is a thousand of your inventions. And we can play this in background mode if you want.

Yeah, there's no audio. Play it. Ask yourselves as you look at this, do you know anybody that lives in a wheelchair that can do that? Go ahead, play it. That's New Hampshire, by the way, for you people in California. That's water in its solid face.

So we decided out of your hundred plus moonshots that we would focus on three of them. One is the work that you're doing at army, the Advanced Regenerative Manufacturing Institute, which follows on, on the longevity work this morning. Yay. Amazing. Off.

I drove one of these up the stairs at the Eiffel Tower into the Jules Verne restaurant. Everybody else was using an elevator. Who would have thunk it?

Only you, buddy. So we're going to talk about army, we're going to talk about Daisy, and we're going to talk about, of course, first, but we'll talk about first, last, because I know that once we start on first, it's the Last topic we'll talk about.

We have a lot to say about that.

We have a lot to say. Yes, we've talked about this before. And those of you who have been on the Platinum Longevity trip, every time we're on the east coast, we have the pleasure of going to the army facilities in New Hampshire. These old loom factories turned now into organ manufacturing facilities. And I remember we went there three years ago, there was like little room and now we went back and you had just taken over these facilities. So what is army?

ARMY stands for Advanced Regenerative Manufacturing Institute. You've had a number of speakers talk around it and about it. In fact, Nina Tanden, who you just had up here, is a member and we've been helping her turn her dreams into reality.

And Martine Rothblatt's been on the stage before.

She's one of my founding board members of army and we can show you some of the stuff we're doing with her. She is now in our mill yard taking over an 80,000 square foot building. And that entire building is now dedicated to manufacturing, manufacturing lungs and kidneys. It's the first place on planet Earth that's doing that. We will be in clinical trials with a half a dozen different army based products within the next.

So what was the moonshot set for you in this? This is initially funded by the government.

And is still today. And by the way, not that I think there's fate here, but three incredible things have happened to me after I touched down in California yesterday. Yesterday I got a call that apparently the FDA has issued on their website. The fact that they just approved our closed loop insulin pump with no moving parts, connected to sensors and has full onboard software to do essentially artificial.

An artificial pancreas to sense your blood glucose level and pump in insulin. No more finger pricks, no more ups and downs. Took enough time.

Yeah, that was only about 10 years in the making. It's another one of my instant overnight successes. So I also found out this morning, 6 o' clock hour time here, they didn't know where I was when I got the call at 6 o' clock. That after a whole bunch of work redone and a couple of reviews and you'll see some slides of some people. Why if we show them that army just got Official confirmation of $100 million. New grant coming, additional grant. Additional grant.

Which brings it to what level of total capital now?

Well over 200 million now. And I thought when they gave us the first 80 million, when we started this thing about six years ago, I was at a press conference at the White House. And I told him at the time, we're going to figure out how to make it practical to take all the miracles of science being generated in all the med schools and all the like. You just heard people like Michael Levin, you've heard people like, you know, well, you bring them all here. I don't have to tell you, but you look at what's going on at the level of science and like Daniel Kraft. And by the way, I apologize, I can't possibly project as efficiently as your speakers who, especially since I don't even know what you're going to ask me. But we looked back then and said it's clear that the science has gotten way ahead of the manufacturing when it comes to, to cells, tissues, and organs. Every other industry, you know, they won the Nobel Prize in the late 40s and 50s at Bell Labs for figuring out how to make a transistor. But within a decade, there was Silicon Valley and an infrastructure to build the digital world that we know of. 100 years before that, you know, the first cars became obviously a real deal. And Detroit built an infrastructure. Iron and steel and castings and forgings and gears and, well, all the different med schools, all the different research institutions had petri dishes. You heard Nina talk about it, and petri dishes and pipettes and slave labor like postdocs and grad students that will do all of this work. But there's no equivalent of Silicon Valley that will bring the engineering community, the manufacturing community, to the world of science. So we told the government, we're going to make it practical to manufacture high quantity, high quality, reasonable price cells, tissues, and organs. I've been building dialysis equipment for 30 years, and there's 200,000 people waiting for their kidney transplants, and 20% are dying every year. And the list gets longer, not shorter. Same thing with waiting for islet cells or a pancreas. People that are waiting for a liver don't have the equivalent of dialysis. So if they're not on that list and lucky enough to get a cadaveric liver quickly, they die. People are waiting for lungs. So we said, we got to stop this, and we shouldn't have to wait for people to die in order to let somebody live. Let's just remanufacture organs. And we also said to them right up front, we'll use the IPSCs, the induced pluripotent stem cells out of the patient that you know will be the recipient to be the cells we put into the printed or by any other means, manufactured infrastructure.

So it's not just any organ, it's your organ.

It's your organ. And by the way, in that same press conference, I said to the folks at the White House, even if we're lucky enough that within the five years I told you, we'll get something in front of the fda. We don't even know how they're going to be able to evaluate it because everything they do at the FDA is, it's of course appropriately statistical. If you're going to make 12 billion of these pills, prove that they're the same. I said, we're going to show up at the FDA and say, yeah, we're making organs. And by the way, even though we're going to make 100,000 kidneys, we hope in the first year we get out there with them, each kidney is going to be very specifically different. Each kidney is going to have the DNA of the intended recipient and it's going to pop out of the oven nice and warm. It's going to be immediately whisked into a surgical field, handed to a surgeon who's going to zip it into the patient and they go home, sorry, fda, there's no way you can be in the middle of that process.

That's a QA for that person.

Yeah.

And so we said to them, I said in the White House, unless we start now, we'll be five years ahead of the FDA when we have the capacity to do this. They're going to need to come up with a complete regulatory strategy to make this possible. The first full time employee of Army, I called it army in respect for the dod. It wasn't, by the way, HHS or it wasn't all the places you'd think that we get health care funded. National Science Foundation. No, it was the Department of Defense that gave us the money because they said, dean, we need skin, we need bone, we need this stuff. So I'm down in Washington, we tell that story. And I said, the FDA is going to be the biggest uncertainty in this whole thing. I'm sure the scientists will deliver the recipe to make cells, tissues and organs. I'm sure we're going to find a way to do high volume manufacturing to get consistent quality and outcomes and document the thing. But how are we going to get it approved? A guy that spent 18 years, MD, PhD at FDA rising to being the policy director at The C. Burr, 1/3 of the FDA, that's that, resigned that day and moved up to New Hampshire.

Coincidence.

Coincidence. I told him he should resign, get to our side of the table and help us prepare to help the FDA partner with us to get these things approved. So Dr. Richard McFarland became the first full time employee of Army. I then said we need standards. So we went down to Washington, we plucked a few folks out of nist, the National Institute for Standard and Technology. We got them on board. Army now has 200 member organizations, most of the big med schools, some of the big pharma companies, a lot of little startups and it has probably about 60 full time employees across all the disciplines. Necessary. Let me make organs, let me make.

This palpable for folks. So we're talking about if you should need a backup, let's list some organs here. First of all, bone, ligament, bone, the work that Nina is doing. Skin.

A kidney, kidney is a very, very important. And livers and lungs. But we now have a little one that's about to go in front of the fda. Think about this people. Most of you hope to live long. We heard all about longevity. We already know that something that was once considered rare is becoming quite an appropriate fear among people getting older. And that's macular degeneration. Well, instead of building the entire kidney, what if you could make something that's about a couple of millimeters by a couple of millimeters and you could slip it in almost non surgically attached to a retina to give somebody essentially their own brand new healthy ability to see. We have now built a device that's spitting those things out. We're testing them in animals. But I'm believing that within certainly a couple of years that will be in front of the FDA and your worries about macular degeneration may be substantially reduced.

Pancreatic islet cells. So regrow some pancreas.

So I started 40 years ago when my brother was still in med school and I built for him little pumps that were used to deliver the first insulin for diabetes. A long time went by and I only started making these solid state ones when it started a decade ago to become clear that we could build closed loop control systems with reliable glucose sensors. And I'll show you something in a minute about that if you ask. But it turned out that nobody wants to deal with insulin whether it's in a pump or not. I mean we've gotten a lot better. Nobody wants to wear CGMs. And your 6 year old daughter or granddaughter shouldn't have to be careful about having that ice cream cake at that birthday party. We've been saying for a long time let's just make new islet cells, new beta cells. Let's make a pancreas. I have been working with jdrf, one of the most prestigious organizations for dealing with this issue for 30 years because I started making pumps for them. The only thing I used to know about JDRF was every year they have a big fundraiser every year I go, we like everybody else, write checks to them. Last year when they came up and saw the scale of what we were doing in the bioreactors we were building, the JDRF came to us and said, we'd like to give you guys a few million bucks so that you can start building massive quantities of islet cells so that we can give those to every researcher that we now fund around the country. So instead of spending an enormous percentage of the money we give them for research where they're essentially building their own tools before they get to do their work, it solves two problems for them. If every different university or research organization has to make their own island of beta cells from their own parts, the variability is so large that nobody's even going to believe it's something you could duplicate. Which is why medical journals write papers and half the paper is about what did we do? And everybody else tries to duplicate it and they typically can't. JDRF said to us, let's make standard line of cells. We'll give them to everybody. Then they can spend all their time and all their money on their version solution. And the example to you would be is if you had builders in every community and you all want them to build you a house, but if every builder, after you approved what they're going to build for you, they had to go out and make their own hammers, make their own nails and manufacture their own tools. No way. So JDRF did that the night. The reason I couldn't come out for the first day yesterday is the entire board of JDRF and a lot of their major funders and recipients showed up at my house for a celebration dinner night before last, where we announced to them and showed them a couple of bioreactors that are making a few billion islet cells per day at this point.

Two billion islet cells per day.

And we're starting to. Within the next few months we'll be shipping some of them around the country. Yeah.

And you can make hearts.

This is over a year old now. And this is Doris Taylor's heart. That was a decellularized and then recellularized tiny pig. That heart is the right size to transplant into a baby. If any of you know somebody waiting for a Transplant of any kind of organ, even hearts in particular. It's a long, terrifying wait for a typical adult. But frankly most of the cadaveric organs that are available are adults. Some idiot kid gets drunk, drives his motorcycle into a tree. Well, you get a bunch of good organs, but they're typically adult size. Think about a baby or a small child that needs one of these organs. You really want some other baby or small child to have to die. So we said let's start making pediatric sized hearts. This thing is re infused with some IPSC's and you saw pumps.

Amazing.

We will be putting some of these quote manufactured hearts in animals this year.

I remember having a conversation with Elon about manufacturing and the comment he made was so astute and it applies to everything you're doing here. He said if you have the ratio of the value of the invention idea relative to the difficulty of productionizing and mass manufacturing, it basically is like one to infinity that the ability to actually go into production and produce this. And you're actually building, you're taking over all of those buildings. And what's your vision a decade from now? What's this New Hampshire facility going to look like Again?

I'll be able to show you a slide of that. The old mills he's referring to, I can show a picture of this. But that mill, the Amoskeg Mills was the largest single operating industrial complex in the world at the time. They had 22,000 water powered looms in there. And they were producing a massive amount of the world's then advanced technology. Knitting, textiles. After the Great Depression they pretty much closed. That stuff became a commodity. That mill yard was virtually empty when I moved up there 40 years ago from New York. I moved into the very smallest building right in the middle there. The white one with the white roof next to the one that's eight shaped. Those were all white because I had to put roofs on them. Now every one of those things shows either one of my DECA companies, one of the army companies first, our university affiliation to train kids to become the next industry. But that's now we have a couple of million square feet. We told everybody, and I told you this years ago, if army works, it's not a product, it's not one organ, it's not one company, it's an industry. This is the birth what Silicon Valley did. Once we understood semiconductor technology, this is going to be the epicenter of an industry to make it practical to manufacture human cells, tissues and organs. So I said we'll call, they got Silicon Valley. We'll call ours Carbon Valley on the east coast. We're carbon based. People said to me, dean, don't use the word carbon. Okay, so we'll be Regen Valley. So we started calling this region valley. And just a few months ago, when we were told we might get the next hundred million, oh, I started to say after three years, I was a little nervous and it was harder than we thought. And I had burned through a lot of the 80 million, and I thought they might not be happy when the DoD is the assistant Secretary of Defense, Vice president. They all came up. They were so blown away by how fast we were moving. By the way, that's both of my senators, Shaheen and Asin, our mayor of our city, and Gina Raimondo, the Secretary of Commerce. A few months ago, when the President of the United States, Biden, asked everybody to be there when he went broadcasting from the Oval Office, the fact that they have officially, through eda, the Economic Development Authority announced, this is the President's words, that the Manchester Milliard is now the epicenter of Regen Valley for the United States and the world.

So can we just take a second and just appreciate that? So I'm imagining a decade, a centralized factory facility where, ahead of your need of an organ, a skin sample is taken, it's converted to an induced pluripotent stem cell, it's put in one end of your bioreactor, it's multiplied some tens of billions of times, differentiated appropriately, and out the other end comes a functioning organ. Did I get it correct?

You got it exactly right. And in fact, to make sure that freshly baked right out of the oven, they're not going to have that long a life. So separate from army, which is this, in that same massive building that they're standing in, I put a little outpost of DECA that's building a thing that we call the pod. There may be a picture of that. And that pod is a life support.

System for the organs past trip. Yeah.

And we now have taken cadaveric kidneys, for instance, that typically after three or four hours, no surgeon would put them in. Somebody after four days of putting it in this little thing, which, by the way, is now on wheels, and we roll it around the entire campus just to prove it has onboard electric power, but it has nitrogen, it has oxygen, it has CO2, and it's on wheels and we're driving it around. And after four days, that thing, which is full of sensor technology that's measuring the kidney that we put in there is making more urine than when we Took it out of the cadaver, it's in better health than it was. And now we're working, as you know, with Martin Rothblatt and Bethe to build a vertiport by which it will be put into one of our vertical takeoff machines. It will be flown either to a local hospital, one of the local ones like Harvard, we're halfway between Dartmouth and Harvard. Or it'll get right to our airport, get put in a plane, delivered to any transplant surgeon in the country, and hopefully we will eliminate the now multi year backlog for people waiting for organs. How many, by the way? The FDA in a surprise, in a surprise. We told them we're building this thing to do life support systems for this. Or we showed them what this thing is. They sent back a note to us. We're giving this product what they call breakthrough status so that they can accelerate the review of it so that we can start supplying these things even to today's organs, so we don't lose.

Amazing. So this is the challenge of when you get home and you start telling your loved ones and your business partners and your employees and so forth about this facility in New Hampshire that's manufacturing organs based on your individual DNA. This is an incredible world we're living in, buddy. Now, let me just ask, you got your PhD in cellular physiology and your medical degree from where? I've forgotten.

So you should know. And I think we got video of this when I am at the White House when they asked us to come down, the President, to announce that they were so excited to give out the first ever $80 million to an engineering organization to make this practical. I'm at the podium and I said, just for the record, everybody, I know nothing about the magic goo that's being made by all these universities. I'm not a biologist, I'm not a biochemist. And whether, whether that petri dish is full of grandma's chicken soup, big molecules, small molecules, biologics don't know. But we know how to move it, measure it, control it, we know how to monitor it. We will figure out how to bring the engineering discipline to the scientists. And if they can deliver the recipe for what they're doing, we will take their artisan approach of being able to do this very expensively, very unrealistically in terms of quality systems. And we will bring it to scale. So I have no PhD in any such thing.

I just want to point out that the majority of individuals who've changed the world are coming with a clean sheet of paper and no preconceptions Right?

But that helps you because if you start with the system that you now have, your natural tendency is to incrementally make it a little better, which is a pretty good thing. We live in a world where you'd all like the things that you're comfortable with to get a little bit better next year. But when there's gaping, missing things, using standard technology to eventually get there is a fool's errand. I mean, the light bulb was not an incremental improvement over a candle.

I could not have said it better.

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All right, so please hold that moonshot in your mind. It's one of the hundred or so, but we're one of the three we're going to feature right now. The second one is got a beautiful name called Daisy.

So, Daisy, some of you might remember that a few years ago we had this pandemic. And again, I know nothing about magic goo. I don't know why. Spike proteins. I don't. That's not what we do. I've got now at deca about a thousand engineers, but they're mechanical engineers, electrical engineers, systems engineers, controls engineers, plastics engineers. I got mathematicians. I do computational fluid dynamic. We got a lot of really smart people. We don't play with magic goo.

By the way, is Daisy off the record for the group? Can people talk about this, Tweet about this record? It may.

Fine, you may now.

Yes.

You couldn't last time we showed this to you. In fact, I may stick one on you right now. So it turns out, it turns out that in the midst of hearing that a couple of major companies, including little guys like Pfizer and Moderna, were working on vaccines, it became clear that they were probably going to get there again. It's a testament to how fantastic science has become. But once they got there, it was pretty well known that, holy mackerel, we're going to need, just for Americans alone, 3 or 400 million doses for the world. 8 billion doses. And the manufacturing capability, even for those big guys isn't going to be there. Not only is that a problem, but you need 8 billion syringes. They'll be filling the ocean. Polypropylene. You need 8 billion little 24, 25, 26 gauge hypodermic needles, hard to make and hard to get rid of. And they're used for nefarious purposes. Glass vials full of this stuff. And by the way, you then need trained clinicians to deliver this stuff. And even in this country, we were being choked. What are you going to do around the rest of the world, particularly developing world? But we were told, and it turned out that if you do a little research, it's True that it's been known for more than 50 years. That's why I said incrementalism doesn't work. It's been known for more than 50 years that vaccines in particular are way more effective if they're delivered intradermally into your skin, not through your skin. And to this day, the only legal way to read the label copy. The only way to give a vaccine, like most other things, is either intramuscular, deep into your muscle, intravenous or subcutaneous. You poke through your skin and it goes into the interstitial space and gets absorbed. Why? Because your skin's so damn thin, not even the best surgeon in the world is going to be able to take a needle, push it in, but not through your skin, and then deliver the dose. It would be like telling all of you, my liver and my kidney, my lung and my pancreas, they're all in a pouch. My peritoneal. And I put it all in a balloon and put some fluid around it so that they can float around in the balloon. Then you go to somebody and say, take this needle, push it into the wall of the balloon, but don't pop the balloon. And then deliver into the balloon a little. What the medical people call a little bleb. Well, it turns out, and the mechanism of action is apparently well understood by people in the clinical space, that the reason you'd love to deliver a vaccine into the skin and not through the skin is because nature's pretty clever. And your body has cells whose sole function is to warn your body, make antibodies, there's something bad that's gotten into you. Well, if you put the cells that are going to tell your body to start making antibodies in your liver or kidney or heart or lung, it's a little late. It would be like having a parachute that automatically opens on impact. What nature did is it said, your skin, your skin, which is the largest organ in your body by weight other than bone, your skin has 100,000 times higher density of these dendritic cells than any other organ in your body. So we said, why don't we just come up with a simple way to put the vaccine directly into, not through your skin. Turns out you'll need less than1.10 the dose. So if Pfizer could make 100 million doses and you need 1cc, well, now that'll be a billion doses, because you need a tenth as much. There's no pain, there's no side effects. You wouldn't need a professional to make the delivery. It has all sorts of Advantages. You can ship it around easily. You don't have waste like syringes and needles. So we set out to do that, and it turned out there was a company, an Israeli company, that had pointed the right way. They were using semiconductor technology to make the world's. I have the best machine shop in the world and the best plastic molders. We couldn't possibly make needles 500 millionths of an inch long, so sharp that they. You put them on your skin and you can't even really feel it penetrating the stratum Corneum. But semiconductor technology can do it. Put up a picture here, and I'll show you a wafer, which is a semiconductor wafer that has these microneedles on it. And on this single wafer, there's 75,000 of them. That wafer there comes off the same machine that makes your processors, your memory. There's a blow up diagrammatically next to it. The hole in that thing is a hundred millionths of an inch in diameter. The length of it, it is so sharp it'll easily pierce your skin. So we developed this. But we said, and I'm sure you all remember Pavoy's equation that says that the flow through a cylindrical cross section varies as the inverse fourth power. Well, it turns out that to push any fluid through this thing is going to take a lot of time and nobody's going to stand there and do it. Also, a baby's nice, soft skin or a young woman's nice, soft, fleshy skin and my old, cruddy, leathery skin are so different. How are you going to do it? You need to eliminate technique. So we made a thing called daisy. We made a thing that looks like the petals of a daisy. It's got a band aid piece on the bottom of it. If you push it down on your skin, the first thing that happens is the daisy petals stretch. They go flat. Like take an orange peel. Well, as they go flat, they become like a drum head for the skin underneath, which makes by the time you push hard enough, you're directly against the skin with these sharp needles. Then there's a tiny little bleb. There's basically about the size of a baby aspirin, volume of space on the top side. And when you push hard enough essentially to trigger this thing, a little spring in there will put about two pounds of pressure on it. So even though it takes two minutes to deliver this tiny, tiny amount of drugs, nobody has to stand there for two minutes with a needle and a syringe poking your arm. So you know, it was simple. It only had about 20 parts. We had it in design, develop, manufacture, do the injection molding, the tooling. Anyway, there's a video of this. We did our own in house. This one we don't have to tell the FDA about. We did our own little in house study. All we delivered was 110 of a cc of saline to see that we get a nice bleb. And I did a cross section. I'm fortunate. I have some of my employees are young, right out of school. Some are geezers like me, some are men, some are women, some are Asian, some are African. Let's play this video. So we made some of these things. We did all the tooling and we called it Daisy for the obvious reason. Now, we did this little hokey thing because I figured I better take this thing to the FDA and tell them what's coming. These are people inside my company. He's one of my engineers. That's his actual child. We didn't get a release from his child, but he's now only using the alcohol because we wanted to show, you know, makes the band aid stick. You really can't feel those needles. It feels like you just pressed a piece of sandpaper on your skin. Now, yes, it worked on that little girl. And these are all a bunch of different people inside deca. Now we're going to do a time release there. We're going to wait two minutes and each of these people pulls it off to demonstrate that that device during that two minutes delivered a tenth of a cc. There's the bleb. There's the bleb. There's the bleb. There's a bleb everywhere. So we took this to a couple of big drug companies. Unfortunately, we'll probably do all the clinicals outside the US We've been.

That was your alternate name for the device, the bleb, right?

Yeah. Anyway, we are now at a point where we have three or four major credible pharma companies that realize this could be used for dengue fever and lots of other things in the developing world. We are in the process of organizing a various set of clinical trials for that. But I'm hoping by the next time a pandemic hits this country, you won't have to see syringes and needles and large volumes and get fevers and muscle, all the side effects go away and we'll have a. We were told, by the way, by the clinicians, many of them who graduated medical school probably long before you said, we haven't seen a new method of delivering a drug into a person since they developed the needle, which was essentially during the Civil War. Anyway, we're very proud of that thing and we'll see how it goes.

Did you see the movie Oppenheimer? If you did, did you know that besides building the atomic bomb at Los Alamos National Labs, that they spent billions on biodefense weapons, the ability to accurately detect viruses and microbes by reading their rna? Well, a company called viome exclusively licensed the technology from Los Alamos Labs to build a platform that can measure your microbiome and the RNA in your blood. VIOME has a product that I've personally used for years called Full Body Intelligence, which collects a few drops of your blood, spit and stool and can tell you so much about your health. They've tested over 700,000 individuals and use their AI models to deliver members critical health guidance, like what foods you should eat, what foods you shouldn't eat, as well as your supplements and probiotics, your Biological age and other deep health insights. And the results of the recommendations are nothing short of stellar. You know, as reported in the American Journal of Lifestyle medicine, after just six months of following Viome's recommendations, members reported the following a 36% reduction in depression, a 40% reduction in anxiety, a 30% reduction in diabetes, and a 48% reduction in IBS. Listen, I've been using Viome for three years. I know that my oral and gut health is one of my highest priorities. Best of all, VIOME is affordable, which is part of my mission to democratize health. If you want to join me on this journey, go to viome.com Peter I've asked Naveen Jain, a friend of mine who's the founder and CEO of viome, to give my listeners a special discount. You'll find it@viome.com Peter all right, your.

Third moonshot and then we're going to go to your questions, a subject near and dear to your heart. And I remind everybody the first time you and I ever met in your office in New Hampshire, the conversation was very clear. I was there pitching him on X Prize before I had met Anousha, had this idea for this prize, wanted to do space flight. I had some people tell me, you got to meet Dean Kamen. He's amazing. And he said, peter, let me make this very clear. There's one, one organization that has priority in my life above everything else and that is first. And as long as you support first and what I do in first, then I'm happy to support you. And I am Happy that I and my family have been able to hold true to that and that you have been an extraordinary support for xprize and abundance. So let's talk about first.

So I am here to talk about first. And all of you should know I am unabashedly. I will grovel, I will beg, I will scream, I will threaten. I don't care. I think this planet of ours is in a race to develop enough technical competence across now 8 billion people soon, probably more. We're in a race between staying at least one step ahead of catastrophe through better technology or losing the race to a global catastrophe, man made or otherwise. And I wouldn't be confident if I were all of you. Don't worry, we'll win that race. I've Learned over the 32 years now of trying to build first that there are actually very, very, very few people, when you look at the denominator being 8 billion, that are either going to make that happen or not. And I'd like to say I don't want to embarrass him, but I want to embarrass him. I would tell you the reason I've never turned Peter down when he's asked me to do these things is I always think I get more out of it than he does. I almost feel guilty about it sometimes, but not to stop, but. But I also used to ask myself all the time, how does Peter, year after year, create a bigger, more incredible group of people that he can put in one room that do what they do? And I know, I've told you this year after year, I don't know how he does it. But in listening today and after you played that thing last night for the do it my way, it occurred to me, Peter, and think about this a second. People are mostly driven, not in their day job, but their passion, whether it's the religion or by being part of a group that shares an idea. And as I listened to everybody over the last day or two, I realized what Peter's magic is, is he's figured out how out of the 8 billion people to find a very, very small group of people. And it is small that shares three important characteristics that makes that group even smaller, because it's the Venn diagram of people that have a lot of resources. And, you know, you find people with a lot of resources. And you've introduced many to me and I thank you for that. You introduced me to Martin Rothblatt, to the guys that funded the entire Mexico. I mean, it goes on and on. People with resources, because people without Resources get up every day. They're worried about whether they can feed their kids. They don't have the tools, they don't have the resources to change the world. They have to deal with what they get. But a lot of people have powerful resources. Most of them use it as a weapon, not a tool. They come into this world and if they have more resources, they use it to take more out of the world. He's found the people that have resources, and for some reason, he's found the ones that want to put something back into the world that makes it an even smaller subset. And then he. I'm going to stop. I will just tell you. I have a feeling that we ought to, like, give him some kind of title. And I was thinking of that today. And I think it's like you. You are like the Pope of hope. No, no, no. I used to think I was going to start. I was going to start my own organization. I used to tell people, they asked me, am I religious? I said, yeah, I belong to the holy order of the sacred differential equation. And people used to tell me, you know, love makes the world go round. I said, well, actually, it's angular momentum. But I realized that if you're going to get the world to do the right thing, and if you're going to find a way to get a lot of kids really smart, you can't just be analytic and academic and technical. You need to find people that have resources that are willing to come together, that are willing to do something that will make the world a better place. He's the only person I know that spends his life trying to collect these people. And I'm just here to steal a few of them to help us. So with that as background, 32 years ago, I started a not for profit organization called First. I called it first for inspiration and recognition of science and Technology. Because I thought at the time that this country was totally misguided. When all of our political leaders back then, all of our business leaders, all our education leaders thought everybody knew we're producing way too few scientists and engineers, this country was going to lose its position, which we've seen what's happened now. And they all said, it's an education crisis. I'm an inventor, right? What do inventors do? Inventors look at the same problems as everybody else and see them differently. My mom is a teacher, and I would sit at home and say, do you really think suddenly we have an education crisis in this country? Even back then, 32 years ago, we spent more money per capita on Education, public education, than any country in the world. I said, it's not an education crisis, it's a culture crisis. And it's not what we don't have enough of. Schools, textbooks. It's what we have too much of distractions and false heroes. And the only people that little kids 30 years ago and now at the Internet, it's even worse. The only superheroes they could name came from the NBA, the NFL or Hollywood. And in a free country where you get the best of what you celebrate, we celebrate sports and entertainment, which is why the US produces great sports and great entertainment, Physics and math and not so much. So I said, kids love sports. Let's just turn physics and math into a sport. I thought it would be easy. We would do it a year of example. People would see how much fun it is if you did it as an after school aspiration event, just like football or basketball. And I just thought this is a no brainer and everybody will adopt it. It'll be as fun as any other sport. But it'll be the only sport where every kid on every team can turn pro. So this is a good deal. And it grew from 23 teams in year one to 50 to 100 to 200 because I needed mentors, I needed superstars in my sport like baseball and football have them and Hollywood has them. But we were reaching a point where I needed more media attention, we needed more resources. And he's referring to a conversation I had with him at the time. And I said, peter, you have to help me get more awareness for first. And he did. And every year since we've worked together and it's grown this year and everybody makes fun of me when I take out my little this year, March Madness, we're in the middle of it. The season got so big that instead of my one little card with the front being first and the back, which was for the first five years, come to Manchester with the 23 teams. You now have to open it up and look at the schedule for 2024. And you see 182 cities holding events for 82,000 schools, with 82,000 schools with 200,000 volunteer mentors. We gave out $80 million in scholarships down on scholarship pro last year at the championship in Houston, where it will be this year from the 17th to the 20th of April. It's an incredible collection of passionate parents, teachers, community leaders. Every one of the Fortune 500 tech companies is a big sponsor. And I'm going to show a quick video of what we did to get first thank you, sir. Up bigger and better. And I really thank you for giving me this opportunity, because you're all going to end up with homework in a couple of minutes out of this. Yes, but what happened was after about 25 years of running first, because almost every big company is multinational, I would go to the championships and there'd be teams from 40 or 50 countries. And that's because, you know, the big companies were. They're international, so they would send the kids around. I ended up being in Israel at one point and before he passed with Shimon Peres. And by then there were 500 or 600 teams in Israel. And by the way, the Palestinians, they're all working together. He then says to me, it's not good enough that after 25 years, you only have 40 or 50 countries. Dean, this should be an international sport like the Olympics, and every country in the world needs to participate. Under the condition that he agreed to be my honorary chair, I founded a sister organization to first called First Global. And I said, I'm going to get one team from every country in the world. I thought that's a modest goal. 54 countries in Africa, one team per country, 24 countries in the Middle east, one team. And I'm going to show a quick set of pictures. But besides, first, as I just told you, being on a tear in this country. And by the way, somebody give me my little kit quick. Year after year, I've said we ought to have first in every school in the United States. It's a cheaper sport than football, basketball. You have less likelihood of breaking your knees or necks. Let's make this in every school. Finally, over the last year, I was able to work internally to create kits where for less than $100, we can build a very sophisticated processing board. And I went to our governor in New Hampshire, and when I told him what we could build, a robot kit for the governor of New Hampshire. And this is public now, and you'll see it said, dean, you've been beating on us for years to make it a standardized sport like the others. If you can give us a kit like that with the curriculum to go with it, and kids love building things like this. He said, it's under 100 bucks for you to build it. I said, yeah, we'll give them to you at whatever they cost. The governor of New Hampshire said, we're not going to put a First team in every school. We're going to put a First kit in every classroom in the state. And we did it. This year. This kit costs less than a typical textbook. And kids don't even open textbooks. They're not relevant. But they do hardware, they do software, they do development. They work in teams. And knowing that you've got little kids, you now have a first robot kit. And we're going to be trying to get other governors to make this a standardized national sport. But back to First Global.

And by the way, let me just ask you guys, as we're going through this, please post your questions and upvote questions in the app, if you would, if you've got questions popping up in your head. I just want to make sure I get us out of here on time for the party. And I can never stop Dean. I'm talking about first.

So after, sadly, he passed away a year before that. But I said, let's invite every country in the world to send one team. And I figured we better do the first one in the US because I needed support. And I thought I'd get 30 or 40 countries. I got 136. I was desperate. I rented, I rented Constitution hall in Washington, and we had 136 countries there the following year. Next slide. We said we're moving. It's an international thing, like the Olympics. It has to move every year. We went to Mexico City. There it is. We had 166 countries. And on that stage is Anoush Ansari, by the way, who's helped us every year. The following year, we didn't have 166 countries. We went to Dubai, the belly of the global beast, the Middle East. And we made a deal with the royal family that every country in the world is going to be invited and treated well. And so all 24 countries in the Middle east, including Israel, is in that arena. We had 191 countries. We had 190 countries, but 191 teams, because one team from Afghanistan to Zimbabwe, we'd always line them up alphabetically for opening ceremonies, like the Olympics. And as the guy is reading from the gets to the Hs, Haiti and Hong Kong, Honduras, he reads Team Hope. And a bunch of kids walk across the stage with their flag. But their flag was our first logo. And he's reading that this is Team Hope. These students have no country. They grew up in a refugee camp in Syria. They have no country, but they have hope. So they are Team Hope. And they've been with us every year. So it gets better. It gets better. We had a couple of years of COVID and then the year that we came back, which is a year and a half ago. Now we said, let's go to a safe place to restart. So we went to Geneva, a place that convenes the world. So we did that. And at the end of the that event, I always feel compelled to remind people it's not about the robots, it's about bringing the world together. It's about important things. So I'm standing on this stage and you'll see why this is important in Geneva. And I'm looking out at 190 flags being waved. And I said, hey everybody, we just finished a great time. You've proven that you all know how to get along with each other. Sharing parts, sharing ideas, teaching each other you're way better than your parents and grandparents, but maybe you'll break this never ending cycle. But I said for next year, just to remind everybody we're not about the robots, I'm going to ask you to sign two what I think are necessary international agreements. And I said, I'm an American and I'm proud of being an American, but I am not going to force on any other country my background or heritage or traditions. But we need something that will be a complement to two documents that I grew up with in America. One is the Declaration of Independence. And we collectively with 190 countries, by the way, I said we need to recognize that while you all need in your country to have your independence and diversity and your language and your culture, keep it all and be proud of it all. But your generation's growing up in a world where pandemics don't stop at the end of an arbitrary line. Go look at what NASA's and global warming affects everybody, no matter where you created the mess. So I said, your generation is going to grow up with a Declaration of Interdependence. And those things that you need to share and support, you're all going to agree to do or we're not going to do this again. I said, there's another document we have in America that I really grew up with and appreciate and it's the Bill of Rights. And I hope in your own countries, whatever is inappropriate set of rights that you're willing to protect, and you should do that. But in our ever more intense global environment, you're all going to grow up in a generation that needs a bill of responsibilities and you need to be responsible to know the truth and speak the truth and respect the truth and respect each other even when you differ. So between now and next year, we're going to make two documents, a Declaration of Interdependence and a Bill of responsibilities. And it will be a universal pair of documents that every country, every team is going to sign or they can't participate in First Global. I did not know at the time that one year later we would start the 2023 event in Singapore. I flew for 22 hours. I got there, everybody's excited. I go to the arena the night before. I'm looking at them setting up for opening ceremonies on October 6th. The following morning, October 7th, I'm watching as opening ceremony starts and alphabetically, these teams are walking across the stage, including Iran, Iraq and Israel. And my phone is lit up. Hamas invades Israel and is it fate? Pete? Peter All I know is I was in a room much bigger than this with kids from every country in the world communicating, cooperating and working together, looking at BBC telling us that the world is about to go into its worst self destructive mode since World War II. For the next three days we had our event and by the end of the third day I was sure I had made giant tablets of those two documents and lines with typewritten Afghanistan to Zimbabwe under them, 191. And I told every team, not knowing what was happening on the evening of the sixth. When we set it up on the morning of the seventh, I said, you're all going to have to sign on these. We've agreed over the Internet all year. Well, by the third day I got there on the 10th, the Global News was horrific. But you'd go in and you could feel the energy and the support and the cooperation. We started closing ceremonies in Singapore. I was so afraid I'd walk out and I would say some, any one group, anyone would have destroyed those tablets or would have put graffiti on them or worse. I walked out people and every single line, every country had a signature in it. And I said to the people there, pack these things up and protect them and send them back to me. I don't know if I'm going to deliver them to the United Nations. No, they're dysfunctional. I'll bring it to Washington. I now have them in the lobby of my building. Maybe I'll give them to the Institute of Peace. But I want you to, this is closing ceremonies and I can give you all copies. Those four tablets are the Declarations of Interdependence and the Bill of Responsibilities and there are 191 signatures on them. Now. We took a lot of the videos of what was going on. The only B roll you're now going to see in a one minute piece. The only B roll we that you'll see here is just from this season. It's what was going on during the world's worst version of self inflicted wounds. And I remember that one of my big sponsors and you know this Coca Cola Mutar Kent joined the board. They're the biggest sponsor of sporting events in the world. And I told him I'll build his little freestyle machines for him if he joins my board. And I built him 50,000 of his machines and he joined the board. And I remembered some of you probably are old enough. All of them that Coca Cola during probably 30 years ago, one of their ad jingles, whatever they are, was a song called I want to teach the world to sing in perfect Harmony. And that refrain was finished with Coke the real thing. And I thought I had images again of the way they did that, showing groups of kids on mountaintops. You probably remember that, of course. And I said, no wonder. They're a great marketing company after 30 years. Kids can't tell you what the law co signs is, but they'll remember that song, okay? So I said to myself, we're going to take that song. I figure I'll go back to them nicely and say, yeah. Anyway, I said let's take that song. Let's write a few new words for it. Like instead of Coke, the real thing first global, the real dream. And instead of it'll be how to innovate. I said we just have to change the words a little. Don't change the tune, don't change the music at all. And with no professional people behind it, our little group made the following one minute piece. And I want you to see this and look at the background, look at the kids and look at their emotion and their attitude and their energy. This is between October 7th and October 10th of last year.

I'd like to see the world unite around a global aim, grow empathies and legacies and work as one in name. I'd like to teach the world to build in perfect harmony to ideate and in all elevate as one community. I'd like to teach the world to lead in solidarity to shape our future ever bright as one community. That's the real dream. What the world needs today. The first go global dream that take us stand today. That's the real dream.

As Margaret Mead very famously said, never doubt that a small group of dedicated people will change the world. That's normally all they quote. The next line is the important piece. She finished it by saying that's the only thing that ever will. Big entrenched institutions have neither the capability, the vision or the incentive to change. If you're fat, dumb and happy on top, you want the status quo. The world's a mess. And if all of you are going to sit back and hope that the politicians are going to fix it. Have you looked around lately again, I'm not trying to flatter this man, but he's brought people together. And I will tell you the third one. It's not just resources and people that want to give instead of take from the world, but we need people with vision and courage. And if you look at the. I don't know how he does it, but he's created this tribe. And I hope you support lots of other things collectively, but some of them are businesses and they'll go. But what I'm really hoping is each time he's invited me to be here, I've come away with a few and sometimes more than a few people that are willing to say, I'm going back to my country or my organization and I'm going to find a way to help you do this. I think if a small group like this is now big enough to measurably change the trajectory of the global connection of the next generation of kids. Imagine every kid on every one of those teams has stayed connected to all 191 of them in a relatively short time, 10, 15, 20 years, these kids are going to be running the world. They can do it collectively, using technology as a tool, or they can do it the way generations before them have in their own tribes, fighting with each other, competing with each other and destroying each other. You guys ought to help us make First Global a bigger global event than the Olympics. It's more cost effective, it's more fun, it's easier to do. And on April 11th of this year, which is coming up, we're announcing where it will be next year. It's a spectacular city. We're announcing what the theme will be, and you've covered it with a couple of your speakers so well, it's unbelievable. We did energy, we did water. When you see the theme, you're all invited. We're going to be at the Meridian house in Washington, D.C. we have the senior senators from the Republican side speaking, the senior senators from the Democratic side speaking, the guy in the middle speaking, and secretary of Commerce. It's going to be a great celebration. It's going to be a great unveiling. That's April 11th. You're all invited. And then the event will be three days. We'll announce what city it will be in and what country it will be in. But sketching right now, it will happen between September 26 and September 29 at the end of this year. And if you come and you bring your family and you bring your friends, it will be the most hopeful thing you've done in a long time. I invite you all to participate.

We've talked about this so many times. Do you believe that our schools, your schools, that you entrust your kids education and is preparing them for the future? There's only one place that I know it's even scratching the surface of that, and that is First. It's an incredible vision, an incredible passion, Dean, that you've given this. It's worthy of a Nobel Peace Prize and the final result, honestly.

But there is.

Yeah, but there is. There's no other institution that has a hope of scaling with this message. What is it doing? It's teaching collaboration between kids and it's teaching that technology is a tool of collaboration. Let me ask how many of you here are currently supporters of First? Would you please stand up? Please stand up. Please stand up. I know we have a few individuals here that are supporting on a national level and dozens of schools. I know my family has been supporters of first now for a multitude of years. I will ask you, above everything else, consider supporting a school. It's about 10k in this country.

Yeah. And by the way, for those of you that didn't stand up, I don't want you to feel guilty. I'm good at throwing guilt ball. My mom's a Jewish mother. But you need to know I feel guilty because after 32 years, I know there's only two kinds of people in this country. The ones that know about first and love it, and the ones that have never heard of it. So how can I blame them? And that's why I come to this guy. Because he's got the best megaphone and the best bright light. No.

My job here is to present to you extraordinary technology. And this is an extraordinary social technology. There are very few things that spread a wave of calming, sentience and mission and purpose.

And by the way, if anybody doubts that putting one team in each new country after 25 years, we only had 40. In the first year of First Global, we had all 54 countries in Africa. Little Rwanda had one team. This is 2018. This year, internal to Rwanda, Rwanda, they had to do a playoff, which is what school is going to represent them at First Global because Rwanda now has internal the way we have first in this country. Rwanda has 500 teams. Turkey has 1,000 teams. Poland has 500 teams. We are spreading this thing. But I'm doing it grassroots people. I don't have sales marketing expertise. We need the resources, the expertise, the passion, the village, the people in this room. We need.

Consider a school, consider a country. If you're a company, get involved. I can't think of something that has greater decadal long impact. But ladies and gentlemen, for a man who has transformed so many industries and is transforming our future more than any single human being, for me, the two greatest heroes on the planet, it's Dean and Elon. And let's give it up for the amazing Dean Kamen.

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