Hans Rosling Is on a Mission to Save the World from Preconceived Ideas. by AMY MAXMEN

The myth buster Hans Rosling is on a mission to save the world from preconceived ideas. BY AMY MAXMEN

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ans Rosling knew never to flee from highest (Japan, 84) than the lowest (Swazi- 500,000 people and found that populations men wielding machetes. “The risk land, 49). He reasons that experts cannot solve with the highest rate of the disease survived is higher if you run than if you face major challenges if they do not operate on facts. entirely on bitter cassava, the only crop that them,” he says. So, in 1989, when “But first you need to erase preconceived ideas,” could grow when drought struck the region. Han angry mob confronted him at the field he says, “and that is the difficult thing.” The plant turned out to contain cyanogenic laboratory he had set up in what is now the glucoside, a precursor to cyanide. Typically, Democratic Republic of the Congo, Rosling LIFE ON THE BRINK soaking cassava roots in water for several days tried to appear calm. “I thought, ‘I need to use Rosling’s ambitions were born from curiosity. removed the toxin. But with streams run- the resources I have, and I am good at talking’.” As a young boy in Uppsala, he listened intently ning dry and families starving, women who Rosling, a physician and epidemiologist, as his father, a coffee-factory employee, prepared cassava had skipped this step — to pulled from his knapsack a handful of photo- described the hardships of the East African their detriment. Dietary amino acids can also graphs of people from different parts of Africa labourers who picked the beans. Rosling and detoxify the poison, but people had no access who had been crippled by konzo, an incur- his girlfriend, Agneta Thordeman, joined stu- to meat or beans that provide them. able disease that was affecting many in this dent protests against South African apartheid At the end of 1981, owing to a number of community, too. Through an interpreter, he and the US war in Vietnam. circumstances including the death of their explained that he believed he knew the cause, The couple studied medicine — she as third child, Rosling and his family returned to and he wanted to test local people’s blood to be a nurse and he as a doctor — and travelled Sweden. Rosling became a lecturer on health sure. A few minutes into his demonstration, through India and southeast Asia on a shoe- care in low-income countries at Uppsala Uni- an old woman stepped forward and addressed string budget. In 1972, they were married and versity but spent time in Tanzania and the the crowd in support of the research. After the seven years later they moved to Mozambique Congo region as well, studying the paralysing more aggressive members of the mob stopped with their two small children. disease he had first observed in Mozambique. waving their machetes, she rolled up her sleeve. He noticed that no matter what country he was Most followed her lead. “You can do anything in, the towns afflicted looked similarly tragic. as long as you talk with people and listen to “Extreme Skeleton-thin people hobbled down dirt paths people and talk with the intelligentsia of the on makeshift crutches, or crawled with their community,” says Rosling. poverty produces legs twisted and dangling behind them like He is still trying to arm influential people anchors. One Congolese community called the with facts. He has become a trusted coun- malady konzo, derived from a word referring sellor and speaker of plain truth to United diseases. Evil to an antelope tethered at its knees. This is the Nations leaders, billionaire executives such as name that Rosling would use in 1990, when Facebook’s Mark Zuckerberg and politicians forces hide he and his colleagues formally defined the dis- including Al Gore. Even Fidel Castro called ease and laid out the evidence for what causes it on the slim, bespectacled Swede for advice. there.” (W. P. Howlett et al. Brain 113, 223–235; 1990). Rosling’s video lectures on global health and As Rosling travelled, he trained African economics have elevated him to viral celeb- Rosling wanted to fulfil a promise he had graduate students who specialized in konzo, rity status, and he has been listed among the made many years earlier to the founder of and together they found that proper cassava 100 most influential people in the world by the the Mozambican Liberation Front, Eduardo processing was the most realistic method of magazines Time and Foreign Policy. Melinda Mondlane. Mondlane had explained that short-term prevention. However, the message Gates of the Bill & Melinda Gates Foundation Mozambique’s future would be challenging often fell on deaf ears because of hunger and says, “To have Hans Rosling as a teacher is one after the country gained independence from conflict. Rosling became convinced that the of the biggest honours in the world.” Portugal, because the nation was so poor and real root of konzo resided not in cassava, but But among his fellow scientists, Rosling education levels low. Rosling recalls, “He shook in economic devastation. “Extreme poverty is less popular. His accolades do not include my hand and looked me in the eyes and said: produces diseases. Evil forces hide there,” he conventional academic milestones, such as ‘Promise you will work with us’.” Mondlane was says. “It is where Ebola starts. It’s where Boko massive grants or a stream of publications in killed by a letter bomb soon afterwards — he Haram hides girls. It’s where konzo occurs.” top-tier journals. And rather than generating did not live to see independence, which came data, Rosling has spent the past two decades in 1975 — but Rosling kept his word. THE TRUE PICTURE OF POVERTY communicating data gathered by others. He The Mozambican government assigned The World Bank defines extreme poverty as relays facts that he thinks many academics Rosling to a northern part of the country, a state in which people survive on less than have been too slow to appreciate and argues where he would be the only doctor serving US$1.90 per day. Rosling can recognize it that researchers are ignorant about the state 300,000 people. Because of the scarcity of in other ways. He has seen it in people who of health and wealth around the world. That’s health care, patients were often in excruci- must walk for hours without shoes to find dangerous. “Campuses are full of siloed peo- ating pain by the time he saw them. Rosling water or to farm eroded soil. He sees it in ple who do advocacy about things they don’t recalls performing emergency surgery to those who remain short because of malnour- understand,” he says. extract dead fetuses from women on the verge ishment, whose babies are born dangerously So now, in the sunset of his career, Rosling of death. He watched helplessly as children underweight and who are trapped with no is writing a book with his son Ola and his perished from diseases that should have been options in life. daughter-in-law Anna Rosling Rönnlund to simple to prevent. “Those years became a sort Ultimately, he says that eliminating extreme dispel outdated beliefs. It has the working title of trauma,” he says. poverty is the only way to cure konzo and pre- Factfulness, and they hope it will inform every- In 1981, he received a letter from an Italian vent other maladies — both social and infec- one from schoolchildren to esteemed experts nun working as a nurse at a remote health post. tious. Money, politics and culture underlie about how the world has changed: how the “Please come,” she wrote. People in the sur- disease in many circumstances, he argues. number of births per woman worldwide has rounding villages had been stricken with sud- Take an outbreak in Cuba that Rosling inves- dropped over the past few decades, for exam- den paralysis of both legs. Separating from his tigated in 1992. The Cuban embassy in Sweden ple, and how average life expectancy (71 years) family, Rosling embedded himself in the crisis. had asked him to find out whether toxic cas-

JÖRGEN HILDEBRANDT is now closer to that of the country with the He was assigned to lead a survey of sava could have caused roughly 40,000 people

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has decreased — still it’s appalling that so many remain in extreme poverty.” Rosling’s online presentations grew popular, and the investment bank Goldman Sachs invited him to speak at client events. His mes-

sage seemed to support advice from the firm’s JÖRGEN HILDEBRANDT chief economist, Jim O’Neill. In 2001, O’Neill had coined the acronym BRIC for the emerg- ing economies of Brazil, Russia, India and China, often considered part of the developing world. He warned that financial experts ignored these rising powers at their peril. “I used to tease my colleagues who thought in a traditional framework,” O’Neill says. “Why are we talking about China as the developing world? Based on the rate of economic growth, China creates another Greece every three months; another UK every two years.” Rosling welcomed the new audience. “They request my lectures because they want to know the world as it is,” he says. The private sector needs to understand the economic and politi- cal conditions of current and potential markets. “To me it was horrific to realize that business Rosling is known for his creative use of visual aids, from sophisticated animations to children’s toys. leaders had a more fact-based world view than activists and university professors.” to experience visual blurring and severe includes nations as economically diverse as O’Neill left Goldman Sachs in 2013, and numbness in their legs. On his first morning Sierra Leone, Argentina, China and Afghani- went on to lead a committee on global anti in Havana, Rosling met local epidemiologists stan. They thought it was all large family sizes biotic resistance. He looked to Rosling for in a conference room. “Then, two men walk and low life expectancies: only the poorest and a big-picture view. “I wish there were more in with guns, and in comes Fidel Castro,” he most conflict-ridden countries served as their people like him,” says O’Neill. “He genuinely recalls. “My first surprise was that he was so reference point. “They just make it about us thinks about the future of all seven-plus- kind, like Father Christmas. He didn’t have the and them; the West and the rest,” Rosling says. billion of us, rather than so many who claim attitude you might expect from a dictator.” How could anyone hope to solve problems if they do but actually come at it with a narrow With Castro’s approval, Rosling travelled to they didn’t understand the different challenges and national perspective.” the heart of the outbreak, in the western prov- faced, for example, by Congolese subsistence Rising wealth pleases Rosling because he ince of Pinar del Río. It turned out that there farmers far from paved roads and Brazilian wants extreme poverty to disappear. To help was no link with cassava. Rather, adults stricken street vendors in urban favelas? “Scientists get there, he celebrates improvements. He calls with the disorder all suffered from protein defi- want to do good, but the problem is that they the UN’s push to eradicate extreme poverty by ciency. The government was rationing meat, don’t understand the world,” Rosling says. 2030 an entirely reasonable goal because the and adults had sacrificed their portion to nour- proportion of people living in extreme poverty ish children, pregnant women and the elderly. has declined by more than half in the past quar- Reporting back to Castro, Rosling couched “Global health ter of a century, and the strategies needed to his conclusions carefully: “I know your neigh- help the remainder are known. bours want to force their economic system on His attitude aligns him with Steven Pinker you, which I don’t like, but the system needs seems to have of Harvard University in Cambridge, Massa- to change because this planned economy has chusetts, who wrote The Better Angels of our brought this disease to people.” After his pres- entered into a Nature (Viking, 2011). In the book, Pinker entation, Rosling went to the toilet. A Cuban argues that global rates of violence are much epidemiologist approached him to thank him. post-fact era.” lower than they were in the past. The two met He and his colleagues had come to the same at a TED conference in 2007, when Pinker took conclusion several months earlier, but they Ola, his son, offered to help explain the the stage after Rosling ended his talk by swal- were removed from the investigation for criti- world with graphics, and built his father soft- lowing a sword (whatever grabs attention). cizing communism. Corroboration of their ware that animated data compiled by the UN Pinker says that Rosling made him think that work from Rosling and other independent and the World Bank. Visual aids in hand, the “the decline in violence might be a part of an researchers supported the policy changes that elder Rosling began to script the provocative even bigger story about humans gradually stemmed the outbreak. presentations that have made him famous. In making progress against other scourges of the one, a graph shows the distribution of incomes human condition”. IGNORANCE ABOUT IGNORANCE in 1975 — a camel’s back, with rich countries Both have been criticized as being Back in Sweden, Rosling continued to teach and poor countries forming two humps. Then Pollyannaish about the global situation in the global health, moving to the Karolinska Insti- he presses ‘go’ and China, India, Latin America face of tragedies such as the conflict in Syria. tute in Stockholm in 1996. But he came to real- and the Middle East drift forward over time. “People think that if you emphasize how things ize that neither his students nor his colleagues Africa moves ahead too, but not nearly as have gone well it is the same as saying no prob- grasped extreme poverty. They pictured the much as the others. Rosling says, “The camel lems remain. That’s not true,” Pinker counters. poor as almost everyone in the ‘developing dies and we have a dromedary world with one “In fact, I strongly suspect that people are more world’: an arbitrarily defined territory that hump only!” He adds, “The per cent in poverty motivated to reduce problems like poverty and

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violence if they think there is a good chance Rosling blames the popularity of the they can succeed.” QUIZ dramatic-sounding statistic on the desire to And as a cognitive scientist, Pinker admires raise funds at a time when refugee crises garner the animations that Rosling uses. One, which financial support. “Global health seems to have depicts countries as bubbles that migrate over Test your world entered into a post-fact era, where the labelling time according to wealth, life span or family size, of numerators is incorrectly tweaked for advo- allows viewers to grasp multiple variables simul- knowledge cacy purposes,” he wrote in the Lancet article taneously. “It’s a stroke of genius,” Pinker says. with Helena Nordenstedt, a colleague at the “He gets our puny human brain to appreciate In some of his talks, Hans Rosling likes Karolinska Institute. The majority of maternal five dimensions.” to explore the audience members’ deaths occur among the extremely poor, they In 2005, Rosling, Ola and Anna founded the misconceptions about the world. He finds added. Those remote populations are hidden non-profit Gapminder Foundation in Stock- that people often perform worse than even from the aid community. holm to develop the ‘moving-bubble’ software, predicted by chance. Rosling prods academics when he can (see Trendalyzer, and to spread access to informa- ‘Test your world knowledge’). For instance, tion and animated graphs depicting world In the past 20 years, the proportion at a Nobel-laureate meeting in Lindau, Ger- trends. Google acquired Trendalyzer in 2007, many, in 2014, he quizzed the audience of and Gapminder has successfully pressured the of the world population living in leading scientists on the average life expec- World Bank to make its data free to the public. extreme poverty has roughly… tancy in the world today. Out of three choices, ●● Doubled just over one-quarter of the crowd picked the HOW TO DISMANTLE THE POPULATION BOMB ●● Remained the same correct answer of 70. That’s less than would be Rosling’s charm appeals to those frustrated ●● Decreased by 10% expected by chance. The quiz spurred laugh- by the persistence of myths about the world. ●● Decreased by half ter in Lindau, but scientists are generally not Looming large is an idea popularized by Paul his audience. Rosling is rarely invited to give Ehrlich, an entomologist at Stanford Univer- keynote lectures or departmental seminars sity in California, who warned in 1968 that Globally, men aged 25 and older because he doesn’t push a single field forward; the world was heading towards mass starva- have spent about 8 years in school he has not made fundamental discoveries since tion owing to overpopulation. Melinda Gates on average. How many years have his konzo days. Researchers agree that he is a says that after a drink or two, people often women that age spent in school? good communicator — but not the kind to tell her that they think the Gates Foundation teach scientists. may be contributing to overpopulation and ●● 2 years “People like Hans Rosling face the criticism environmental collapse by saving children’s ●● 3 years of being too superficial,” explains Peter Hotez, lives with interventions such as vaccines. She ●● 5 years a tropical-disease scientist at Baylor College of is thrilled when Rosling smoothly uses data to ●● 7 years Medicine in Houston, Texas. “It’s the dilemma show how the reverse is true: as rates of child of the public intellectual,” he says, describ- survival have increased over time, family size NATURE.COM ing academics who bridge several disciplines has shrunk. She has joined him as a speaker at For answers and more quiz questions, visit: rather than excel at one. several high-level events. “I’ve watched people go.nature.com/2gkhqxl Rosling says he never cared much about have this ‘aha’ moment when Hans speaks,” she his academic reputation. He was lucky to says. “He breaks these myths in such a gentle receive steady support from the former head way. I adore him.” were losing ourselves in details,” says Rosling. of the Karolinska Institute, Hans Wigzell, The appreciation extends to the World “I saw this was a war situation: all we needed to who encouraged him to seek outside funding Health Organization: director-general know is, are the number of cases rising, falling so that he could pursue whatever he deemed Margaret Chan says that Rosling provides facts or levelling off?” After a few months, it became most important. After Rosling decided that for decision-makers to consider. “He makes clear that the rate of new cases had dimin- that meant teaching broadly, he walked away the case that as people grow in wealth, they ished. Rosling was rewarded with a traditional from research entirely. grow in health,” she says. And his talks help her chieftainship by the Liberian government. He also differs from global-health experts to convince governments that data collection Now, at the age of 68, Rosling has retreated to who have stepped outside academia to change can help them to track whether they are getting his red wooden house in Uppsala with Agneta. policies. He hasn’t worked to expand access to returns on their investments in global health. He continues to work and plugs away at his HIV medication, for example. He has not — like The past few years have brought new chal- “factfulness book on megamisconceptions”. Hotez — put neglected tropical diseases on the lenges. In 2014, Ebola was spreading in West Every now and again, he stirs the pot. In world health agenda. And konzo still exists. But Africa, and Rosling’s liver was failing. A October, he published a piece in The Lancet Rosling has had success; it’s just that the impact hepatitis C infection that he had mysteriously identifying a misleading statistic in a widely becomes harder to measure the broader his acquired in his youth was becoming lethal. He cited report from an advocacy organization goals become. Now that he has decided that the travelled to Japan to receive the newest treat- launched by the UN (H. Nordenstedt and public at large must buy into ending extreme ment, not yet approved in Sweden. By October, H. Rosling Lancet 388, 1864–1865; 2016). The poverty and creating a sustainable world, he has he found himself fretting, from afar, over dis- group claimed that 60% of maternal deaths dedicated the last chapter of his career to educa- crepancies in official reports on the number of occur in settings of conflict, displacement and tion. With the right facts, he hopes, people will suspected and confirmed Ebola cases. “I real- natural disaster. Rosling checked the numbers make the right decisions — he just needs to face ized my skills were needed,” he says. and calculated that the true amount was no down the misconceptions. As soon as the drugs cured him, Rosling flew more than 17%. A UN spokesperson explains Who is better suited to the task than a man to West Africa to join the Liberian govern that part of the discrepancy derives from the able to stave off machetes with the power of a ment’s epidemiological-surveillance team. The fact that in the original figure, women who few pictures and his words? ■ team wanted to consolidate data, but strug- gave birth in nations affected by crises were gled with the disparate ways in which inter- included — even if their region had not been Amy Maxmen is a science journalist in national agencies collected information. “We directly impacted. Berkeley, California.