The most rewarding, beneficial scientific outcomes usually require a bit of sacrifice for those who make it happen. That’s why society needs people like Josh Morrison: a founder of organizations that advocate for and support people who participate in kidney donation and human challenge trials, and an expert willing to take on risks and help make progress happen faster.
Morrison first became familiar with this kind of direct public health participation when he read about kidney donations in the New Yorker when he was a law student in 2009. In the piece, people explained why they gave their kidneys to strangers in need — though there was slight risk to donors, the reward and benefit for the recipients was more than worth it. Two years later, he donated a kidney himself.
Morrison described the donation to me as an “amazing” experience, one that was transformative for someone who was an otherwise unmotivated corporate lawyer at the time. He was spurred to connect with other kidney donors, and to learn about the many problems that hold back organ donation, including the burdensome hidden costs foisted upon donors that make the process less accessible than it needs to be and leave more than 90,000 Americans in need waiting for a kidney.
Morrison decided to finally leave corporate law, and in 2014, founded WaitList Zero, a nonprofit focused on addressing the kidney shortage and making sure donors got the proper support they needed. In 2019, after six years of advocacy, his work helped push the Trump administration to enact the Advancing American Kidney Health initiative, which reduced the cost burden for donors and made it easier to become a kidney donor.
“The basic logic of my work in general is to try to use a sort of identity politics to get better political decision-making,” Morrison told me. “So with kidney donation, the theory is if kidney donors are more empowered in the political system as a sort of identity group, then the system will treat donors better and that will mean more people donate.”
Morrison would take his ethos to the next level during another public health crisis: the Covid-19 pandemic. Stuck in his Brooklyn apartment at the onset of the pandemic and finding himself struggling with what to do, Morrison learned about “human challenge trials” for Covid-19, vaccine studies where volunteers are dosed with either a vaccine or a placebo and then directly exposed to the virus to more rapidly assess the vaccine’s efficacy. While vaccine trials normally involve both groups (treatment and placebo) going about their regular lives with the possibility that they may encounter the virus in the wild, the urgency of the pandemic raised the profile of a more direct trial.
Though challenge trials raise ethical questions, the potential benefit of saving countless lives with faster development of vaccines made them very appealing during the teeth of a global pandemic. As Morrison told my colleague Dylan Matthews in May 2020, “If challenge trials are likely to benefit society, and well-informed people want to participate, we should respect their freedom to do so.”
Realizing elevating Covid-19 challenge trials could be the most important thing he ever did, in the spring of 2020, Morrison helped launch 1Day Sooner. This organization would be laser-focused on recruiting and supporting individuals who wanted to take part in these high-risk, high-reward studies to get Covid-19 vaccines out faster. 1Day Sooner would go on to direct the world’s attention toward challenge trials, and to get almost 40,000 people in over 150 countries to sign up for them. Morrison’s work will hopefully help pave the way for faster vaccine development in the future, including for other diseases and future pandemics.
But Morrison and 1Day Sooner are just getting started. They are working with partners at the Institute for Progress and Schmidt Futures on a project called “Operation Warp Speed 2.0” to accelerate the development of the next generation of Covid vaccines, including universal vaccines that could cover all variants, as well as intranasal options that could lead to better protection from airborne pathogens that enter the body through the nose and throat. They also want to ramp up human challenge trials for neglected diseases like tuberculosis and hepatitis C in order to accelerate the development of more highly effective vaccines.
Finally, Morrison and his team want to grow their work in the UK and Africa especially, preparing for the next pandemic and making sure countries that faced the greatest vaccine inequities are in a better bargaining position via a pandemic insurance fund.
Morrison could have stayed a corporate lawyer, but to really make a difference, he knew he needed to have some skin in the game. What started as him helping one person has grown into building a community of fellow travelers willing to take on personal public health risks to build a more equitable and healthy world.