One bacterium causes roughly 1 in 20 cancer cases worldwide. It’s the most cancer-causing pathogen we’ve found—and the main cause of peptic ulcers. Its discovery overturned an ironclad medical dogma that the stomach was sterile.

Despite infecting about half of humanity, Helicobacter pylori wasn't discovered until 1979 and shown to cause gastritis and peptic ulcer disease in the early 1980s. Why did it evade detection for so long—and what finally broke through the consensus?

I went to Perth, Australia—where H. pylori was first discovered—to chat with Barry Marshall, gastroenterologist and co-recipient (with Robin Warren) of the 2005 Nobel Prize in Physiology or Medicine for discovering H. pylori and proving that it causes gastritis and peptic ulcer disease. Marshall famously infected himself with the bacterium to demonstrate causality and later helped develop clinical diagnostics like the urea breath test, which we demo live in the episode.

We discuss:

• the rise and fall of stomach cancer in the West;

• whether Darwin’s dyspepsia and Napoleon's stomach cancer trace to H. pylori;

• the ulcer–cancer paradox;

• Correa’s cascade: what H. pylori eradication reverses—and what it doesn’t;

• the “H. pylori enigmas” (Africa, India, Costa Rica);

• eradication prospects and an oral vaccine timeline;

• how the field missed the discovery;

• how the primitive internet enabled the discovery;

• what the H. pylori discovery teaches us about how knowledge diffuses;

• lessons from manufacturing millions of tests in Perth;

• and much, much more.

Episode sponsors:

• Eucalyptus: the Aussie startup providing digital healthcare clinics to help patients around the world take control of their quality of life. Euc is looking to hire ambitious young Aussies and Brits. You can check out their open roles at eucalyptus.health/careers.
• Vanta: helps businesses automate security and compliance needs. For a limited time, get one thousand dollars off Vanta at vanta.com/joe. Use the discount code "JOE".

See omnystudio.com/listener for privacy information.

Stagnation! The 2010s witnessed Australia’s weakest productivity growth in six decades.

How much of the slowdown is homegrown? How much reflects the broader “great stagnation” plaguing the West?

How much is simply an artefact of the way “productivity” is measured?

And what would a credible new growth model for Australia—with its distinctive reliance on mining over manufacturing—actually look like?

To answer these questions and more, I’m joined by two of Australia’s smartest economists.

Greg Kaplan is the Alvin H. Baum Professor of Economics at the University of Chicago. He is also the cofounder and chairman of e61, a non-partisan economic economic research institute in Australia.

Michael Brennan is the CEO of e61. He was previously chair of Australia's Productivity Commission and a Deputy Secretary of the Australian Treasury.

We discuss the forces behind falling construction productivity; how to think about “Australia’s most productive company”; where to find quality gains in the services sector; what we can learn from the stunning innovativeness of Australia’s agricultural industry; why we need new economic engines beyond the Sydney–Melbourne duopoly; and much, much more.

Episode sponsors:

• Eucalyptus: the Aussie startup providing digital healthcare clinics to help patients around the world take control of their quality of life. Euc is looking to hire ambitious young Aussies and Brits. You can check out their open roles at eucalyptus.health/careers.
• Vanta: helps businesses automate security and compliance needs. For a limited time, get one thousand dollars off Vanta at vanta.com/joe. Use the discount code "JOE".

See omnystudio.com/listener for privacy information.

Francis Fukuyama is a Stanford political scientist and the author of (among many other works) The End of History and the Last Man—arguably the most influential work in political science of the past half-century.

If “History” is driven by technology, how does Fukuyama now view biotech and AI—and their potential to usher in a new, post-human history?

These are difficult questions, but I wanted to ask Frank about topics that are both important and (at least for AI) on which he has spoken little until now.

We also get a sneak peek at his forthcoming book and discuss his ideas on bureaucracies, delegation, and state capacity.

See omnystudio.com/listener for privacy information.