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#we are both in need of therapy <3
cry-ptidd · 6 months
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Expression study ft Laura and Alucard who look just about fucking miserable
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edsanon · 2 months
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I adore Dogday, such a good boy, wished we could’ve saved him
I think he would make for an amazing service dog
Though he would also need a service dog himself but oh well-
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div-divington · 2 months
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Not to be cringe but...
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Tall-ass tower manifests in city without any logical explanation
Interior has nonsensical geometry and architecture. Building shifts constantly. Seemingly alive.
Shady organisations have tried to manipulate the structure to their own ends.
Linked to an extra-dimensional godlike entity that wants to use the tower to bring about their own goals (Nix and The Board respectively)
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Protagonists unlock their powers by pointing a "gun" that isn't actually a gun at their own heads and pulling the trigger (the Service Weapon is obviously very different to an Evoker but the symbolism is there I think)
Both do this without being certain they'll survive.
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Protagonists have manifestations of their inner selves and their willpower living in their heads. These manifestations are sentient beings that serve as both an extension of the protagonist and a separate character.
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Both of their inner selves also serve as extensions of a separate entity (Thanatos (the Persona) is a remnant/extension or something of Ryoji. Polaris is an offshoot/remnant of Hedron)
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Protagonists are guided and assisted by otherworldly beings who take the forms of older men in service roles (Ahti, who presents himself as the janitor of the Oldest House, and Igor, who acts as the host of the Velvet Room)
Ahti and Igor both appear to exist in a way distinct from humans and can perceive other planes of existence easily.
Ahti and Igor both speak in manners that the protagonists find confusing and aloof but ultimately are trustworthy and good-natured beings.
I've run out of picture slots, tragically, but do you see the vision?
I think a very fun crossover fic or something could very easily be made here.
Additional things for the Oldest House and Tartarus:
Filled with monsters that feed on human consciousness and leave people as husks of their true selves (Shadows and the Hiss)
Filled with fun little lore documents left behind by researchers.
Directly connected to planes that exist between dream and reality (the Velvet Room and the Astral Plane)
Heavily based on mythology (Tartarus is obviously named after, y'know, Tartarus. The Oldest House is heavily implied to either be Yggdrasil or at the very least be an ancient tree that potentially somehow inspired the myth of Yggdrasil/took its form from said myth).
You Are Going To Get Lost In These Funky-Ass Towers.
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echothelover · 8 months
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There were three stages to my development as a Juri fan.
Stage one, you are 100% pro Juri and too emotionally close to the conflict, and thus it hurts when Shiori does anything. Wtf was Ruka's part of the story even about.
Stage two, you relate to Juri just a liiiitttle too much. And you become a Shiori apologist. Shiori may be mean but she's not THAT bad. I mean, Juri is pretty cold to her too. Surely there's a REASON Juri liked her in the first place. Also Ruka GET AWAY FROM THEM.
Stage three, you are now a fan of both Juri and Shiori but please please please stay away from each other til you've both got years worth of shit figured out. Shaking Juri by the shoulders- i get it, i understand, but GET OVER IT. Cheering loudly at the scene where the locket is cut off. Appreciating Ruka's narrative for shaking them out of their patterns (but still hating him so so much and laughing when he dies offscreen). Get therapy please girls. And then, if after lots of self reflection and improvement you still love each other, THEN... you should keep going to therapy but also add couple's therapy into the mix.
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yuukei-yikes · 1 year
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haruka watches takane eat like a dog begging because he knows she will leave at least half its food. sorry i wrote a longer post in the tags.
#but im also attached to the idea after getting her body back takane indulges in food a lot more#i think generally she's just so glad to have it back she stops taking it for granted and is like oh my god EATING#but it goes both ways same with sensory issues#takane is extremely touch/eating/sleeping averse#but suddenly gets this rush and is like i need to binge eat and hold hands NOOOOOOW#<- haruka's match made in heaven moments but he's smart enough to see takane's like overindulging and is like Ok. let's take a break💗#takane gets so overwhelmed both negatively and positively like#omg im real!?!?!? AUGGHH to OMG IM REAL YIPPEEEEE!!!!!!#also working on not taking cover as ene bc at first she did and accidently drove itself craz#so shes like trying to work through it WITHOUT having to resort getting out of her body bc no problems are gonna get solved that way#haruka helping her through it all AUUUHCGGH#i have this very particular hc cuddling its basically therapy ok. because its all touchy and it helps her.#as much as it sometimes pains her so it can be both negative and positive#haruka is like :3 but if takane is squirming all uncomfortable he's like do we HAVE to do this youre NOT enjoying it at all and she's like#EUGH DONT TALK I CAN FEEL YOU BREATHING AGAINST ME ITS DISGUSTING#and haruka's like man when you scheduled to cuddle 1 hour a day i wasnt imagining this💔💔💔#BUT WHATEVER HE WANTS TO HELP SO HE HELPS💗 he just doesnt want her to be all uncomfortable but takane understands she needs it#BECAUSE SHE CAN ALSO LOVE IT IT ALL DEPENDS ON HOW SHE'S DOING THAT PARTICULAR DAY#and as time goes on its more and more that she enjoys it and tells haruka he can now touch her without having to ask first:3#i think at first its exclusively takane who begins any sort of physical contact not bc haruka is shy#but bc he doesnt wanna put her in a weird situation if she doesn't wanna be touched he probably only dares to like hold her hand. ñ#which is her sleeve. bc she covers their hands. lol#BUT TAKANE RLY COMES THRU i think they rly talk abt all this and she rly comes to him like hi. u can touch me without asking if u want.#and haruka's like ?? U MEAN I CAN KISS U WITHOUT ASKING??? AND TAKANES LIKE YEAH!!!and haruka's like OH MY GOD!!!!!!!#hey. sorry for being insane. i have very particular headcanons that i need to share i NEED YOU TO UNDERSTAND ME#did anyone read all these damn tags#god idk why i dont write this as the post itself but then i cant go and copy the tags. what a nightmare#kagevinnie#headcanons
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certifiedunicornhater · 10 months
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Achuchobes & Gordi would need to go to therapy first if they ever got into a relationship.
oh yeah DEFINITELY, therapy is a must they’ve both suffered a lot
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thedreadvampy · 11 months
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aaaaaaaaaaa work is so overwhelming just now I feel like my brain may explode
#red said#i can't tell if i have too much to do or if I'm just being disorganised in doing it!!!!!!#but i was meant to have a full data report done by tomorrow and i haven't found more than 20 straight minutes this week to look at it#the new boss keeps ASKING ME THINGS and ASKING ME TO DO THINGS#and the fucking. readability argument filled up SO MUCH of Monday and Tuesday with both back and forth and silent seethe#i have to be in all her meetings and she's sending me a bazillion things for social media#and my colleague's off on leave so I'm picking up his social channels too except I'm NOT cause i don't know what to PUT on them#need to put together a new video ad by next Friday#need to do like 5 more blogs#and the staff newsletter! gotta get that out by lunchtime!!!! haven't started it!!!!!!!#3 meetings today. gotta do vo recording tomorrow. and both today and tomorrow are short days#cause i have therapy today and I'm taking kofi for a Birthday Treat tomorrow afternoon so i gotta knock off at 12:30#it's all very well to say work to live not live to work AND I DO but the expectations remain!!!!!!#and i feel like I'm failing and being lazy if i can't easily do everything that's asked of me. is my problem.#it's very important to have a manager who understands that their job with me isn't too drive me forwards#but to manage the amount of work that hours my desk because I WILL try to do all of it and i WILL usually manage#but it will absolutely fuck me long term#crying wailing i miss my manager 😭 10 months!!!! come back!!!!!!!#we don't always have the most idyllic work relationship but she knows me very well and i trust her to help not hinder with my stress levels#and also like if i tell her i am spiralling like this she would always help me prioritise#but i don't yet know or trust the mat cover well enough to talk to her about overwhelm. and i feel the need to establish myself first.#like I gotta prove that I'm hardworking and reliable and that when i say i can't cope i mean it and I'm not trying to dodge work#which. boy. working life as a disabled person sure does colour your thinking huh.#gotta first prove I'm EXCEPTIONALLY committed and hardworking and Good At Job BEFORE i can allow myself to struggle
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thedeadthree · 1 year
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arys is so down bad for visenya and u know what? i think thats such good energy for her <3
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catboybiologist · 1 month
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“As a biologist, the terms biological woman and man don’t make any sense to me” okay then you’re an idiot and a terrible biologist. I swear to god, morons like you only become biologists just so you can hold it over others, when in reality, if biology deniers like you can become biologists, then being one really doesn’t mean much anyway. But this probably just gave an autogynophile like you a boner to read, anyway.
Oh fun! Haven't gotten one of these in a while. Disregarding the fact that you somehow think the qualification for being a biologist entirely hinges on defining womanhood, I do need to ask some clarification. I know I'm feeding the trolls here, but here we go: does your definition of "biological woman" mean:
Sociological woman? Eh, context dependent, I'm not fully out of the closet, but oftentimes, I am and present femme. So let's call that one 50/50.
Psychological woman? Because I am one.
Neurological woman? Because I am one [1].
Physical woman? My soft tissue redistribution is handling that well.
Hormonal woman? My blood tests are within cis female ranges.
Transcriptional woman? As a signalling molecule, the downstream effects of estrogen have broad transcriptional effects, completely changing the profile of gene expression and functional genomics of my cells. [2]
Genetic woman? I mean, see my above point- as far as my genes that are actually active, I have all of the same transcripts being produced, controlling which genes are expressed.
Karyotypic woman? I actually have a few signs pre-HRT that might point to a non-XY chromosome pair, but I haven't had a karyotype. We'll put that down as unknown. And hell, even if its XY, there's plenty of cis women who are karyotypically XY, with suppressed sry or complete androgen insensitivity. Interestingly enough, a completely androgen insesitive woman can go her whole life without knowing- and functionally, is very similar to a trans woman, actually. Fancy that. [3]
Reproductive woman? I can't produce an egg cell, but neither can significant fractions of cis women. Also, this is all gonna change soon, which is fun. [4]
There's also a lot of understudied aspects to the biology of HRT and even pre-HRT that are emerging, largely demonstrating widespread cellular and genetic remodeling of trans individuals undergoing hormone therapy. The field is a bit behind due to constant political pressure to revoke funding, but a lot of the results are extremely exciting in both testosterone and estrogen hormone therapies. I'm sure that, as a self professed biology As someone who presumably has a lot of expertise in biology, I'm assuming that you're aware of all of this cutting edge research, and are keeping up with modern papers, including but not limited to these cool findings:
Trans men on HRT exhibit significant genetic and transcriptional changes that make them biochemically male. [5][6]. It's a good hypothesis that the same happens with estrogen treatment, but those studies don't exist yet- I'm sure you're reserving judgment until more publications exist, of course.
Trans men on HRT develop male cell types and tissues. [7]
Trans women experience muscular and blood cell changes that align with cis women moreso than cis men [8]
And many, many more! This is an exciting, underserved, and groundbreaking field of research, and I'm sure you're keeping up with the latest in scientific journals about it.
I'm sure, of course, that you understand that it becomes impossible to draw a distinct line anywhere in here, and that words like "woman" are shorthand for the myriad of traits that invisibly synthesize in our mind and in society to represent a concept? I'm sure you understand that science is fundamentally descriptive, not prescriptive? I'm sure that you understand that these findings, while really cool and interesting, actually don't mean jack shit about what the word "woman" means or not?
As someone who is the ultimate decider in what a biologist is, I'm sure you know that bioessentiallism is a childish mindset that completely ignores and disregards the constantly changing, dynamic nature of biological systems, something that extends well beyond biological sex and its relation to gender.
I'm sure that also, that you understand that beyond just this, that the role of science in society is to advise how to achieve our moral principles, not create moral principles in themselves. And I'm sure that understanding means you know that trans affirming healthcare and supportive societal treatment leads to reduced mortality and increased happiness for everyone, right?
So great to talk to someone who is surely a scientist on this. You are a biologist, if you're talking like this, I assume? I assume you're not going to spit complete misreadings of scientific language from the background sections of these papers that only reveal you've never read a scientific paper in your life if you're thinking this way? I assume you have experience interpreting data like this?
Also, imagining my genitalia while writing this? Ew. Please stop projecting your fetishes into my inbox.
Works cited:
Kurth F, Gaser C, Sánchez FJ, Luders E. Brain Sex in Transgender Women Is Shifted towards Gender Identity. J Clin Med. 2022 Mar 13;11(6):1582. doi: 10.3390/jcm11061582. PMID: 35329908; PMCID: PMC8955456.
Fuentes N, Silveyra P. Estrogen receptor signaling mechanisms. Adv Protein Chem Struct Biol. 2019;116:135-170. doi: 10.1016/bs.apcsb.2019.01.001. Epub 2019 Feb 4. PMID: 31036290; PMCID: PMC6533072.
Gottlieb B, Trifiro MA. Androgen Insensitivity Syndrome. 1999 Mar 24 [Updated 2017 May 11]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1429/
Murakami, K., Hamazaki, N., Hamada, N. et al. Generation of functional oocytes from male mice in vitro. Nature 615, 900–906 (2023). https://doi.org/10.1038/s41586-023-05834-x
Pallotti F, Senofonte G, Konstantinidou F, Di Chiano S, Faja F, Rizzo F, Cargnelutti F, Krausz C, Paoli D, Lenzi A, Stuppia L, Gatta V, Lombardo F. Epigenetic Effects of Gender-Affirming Hormone Treatment: A Pilot Study of the ESR2 Promoter's Methylation in AFAB People. Biomedicines. 2022 Feb 16;10(2):459. doi: 10.3390/biomedicines10020459. PMID: 35203670; PMCID: PMC8962414.
Florian Raths, Mehran Karimzadeh, Nathan Ing, Andrew Martinez, Yoona Yang, Ying Qu, Tian-Yu Lee, Brianna Mulligan, Suzanne Devkota, Wayne T. Tilley, Theresa E. Hickey, Bo Wang, Armando E. Giuliano, Shikha Bose, Hani Goodarzi, Edward C. Ray, Xiaojiang Cui, Simon R.V. Knott, The molecular consequences of androgen activity in the human breast, Cell Genomics, Volume 3, Issue 3, 2023, 100272, ISSN 2666-979X, https://doi.org/10.1016/j.xgen.2023.100272. (https://www.sciencedirect.com/science/article/pii/S2666979X23000320)
Xu R, Diamond DA, Borer JG, Estrada C, Yu R, Anderson WJ, Vargas SO. Prostatic metaplasia of the vagina in transmasculine individuals. World J Urol. 2022 Mar;40(3):849-855. doi: 10.1007/s00345-021-03907-y. Epub 2022 Jan 16. PMID: 35034167.
Harper J, O'Donnell E, Sorouri Khorashad B, McDermott H, Witcomb GL. How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation. Br J Sports Med. 2021 Aug;55(15):865-872. doi: 10.1136/bjsports-2020-103106. Epub 2021 Mar 1. PMID: 33648944; PMCID: PMC8311086.
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angeltism · 4 months
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having thoughts abt somebun I don't even interact with that I really shouldn't be having !
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conanssummerchild · 4 months
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chauvanistic pig tbh
lmao thats the one i was thinking abt you tbh 😭
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angeltrapz · 1 year
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playing investigations again and bratworth is such a little bitch I love him
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The more I read up/hear about autism, the more angry I get at my psychiatrist for ignoring my plea for a diagnosis.
I read autistic people saying things like "I have noticed I was different from a very young age". And especially sentences like this make me angry. Because when I told the psychiatrist that I think maybe I might be autistic because of how different I am to other people, he responded by saying "autistic people don't ask themselves why they are different".
Apparently that's not true. Apparently austistic people are very aware of how different they are or how society treats them differently. So of course you are asking yourself "WHY?"
Now I'm not saying I am sure I am autistic. I may not be. What I'm sure about by now is that I have adhd. Of course those two can go hand in hand, but still. I have a lot of trust in my friend who told me they don't think I'm autistic, but they are sure I have adhd (which I have also been thinking of). Which tbh makes me feel very seen. Someone acknowledging my struggles.
I just think the way the doctor judged me by telling me he "can already see I'm not autistic" because I clearly show emotions and actually ask myself why I'm different... that's shitty. Really fucking shitty. I still would have wished to be taken more seriously and get tested and then gotten a "no" and not just judged on something so unscientific and almost pseudoscientific as "autistic people have no emotions". Holy fuck dude, how are you a psychiatrist.
I also heard sometimes from people that since I'm apparently very intelligent that I can't have adhd or be autistic... cuz apparently you are stupid if you are that. Fuck those people.
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lizzobetumblin · 21 days
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Melissa hated her feelings. 
She buried them in a chest in the 5th grade (along with her ability to express them). Other peoples' feelings on the other hand was her forte. She could process, decipher and regurgitate other peoples emotions effortlessly. This gift could’ve taken her through college, all the way to a degree in psychology. Distinguished Dr. Jefferson with a PhD and a cozy office and impressive roster of high-profile, weallthy clients was a shiny idea. Fate would have a different hand for Melissa her talents were exhausted on mediating family fights, friend group drama, and charming her way out of confronting her own feelings. 
“Feelings.” Even saying it out loud to herself seemed silly. Something reserved for ‘cry babies’ and water signs. Typical Sunday nights started tame, reading or writing fan-fiction and drinking cranapple juice. And then like clock work her father would yell her name, 
‘MELISSA!!!’ Emotionless, she’d get up dust off her Winnie the Pooh shorts and make her way downstairs. On the long walk down the hall to the stairs leading to the living room brawl, she’d go through her check list: 
1.) Don’t cry.   
 2.) Stay neutral; Deescalate
3.)Don’t take anything personal. This isn’t about you
She padded down the carpeted stairs in her old soft socks to see her mother tightlipped and tear streaked thinking, 
‘she broke rule number 1’. Her father, Michael was proud and angry, his big belly filled with self righteousness. She knew he would be unyielding in his resolve and at this point her only option was to deescalate.
 ‘Rule number 2’. Then her sister the water sign and calamity for the evening sat on the floor nearly fetal, face red and raw with emotion. 
‘Its not your fault’ Melissa wanted to say ‘You just didn’t follow the rules… you’re loved.’ But she couldn’t say that because she’d be breaking rule number 3. It wasn’t about how Melissa felt. Even though she felt like screaming,
“VANESSA, YOU DIDN’T DO ANYTHING WRONG. DAD—YOU JUST HAVE PENT UP ANGER BECAUSE YOU GREW UP IN THE HOOD OF DETROIT AS A BLACK MAN IN THE 60s AND 70s. YOU NEED A HEALTHY OUTLET LIKE.. I DONT KNOW… THERAPY?!?!?! THIS IS A WASTE OF ALL OF OUR TIME. I LITERALLY JUST WROTE THE BEST SAILOR SATURN x CHIBI USA FANFICTION EVER AND THIS IS KILLING MY VIBE!”
Instead, she decide to hear every one out. She decided to help. To calm her dragon of a father down. To be a translator for her emotional sister. To not take it personal. To stay neutral. To not cry. 
9 years later, at her fathers funeral she still never broke the rules. She played her flute and spoke at his memorial. She was present for her mother because it wasn’t about her. When other peoples' emotions bubbled up she stayed neutral. She sat through both services and she did not cry. It wasn’t until she excused herself to make a phone call outside did she collapse onto the stairs of the funeral home and weep alone in the cold Detroit snow. 
It’s okay to break the rules sometimes, she reminded herself. As long as no one else sees it.
Traumas began to compact on Melissa, as they do. Humans tend to collect traumas like pebbles on a long hike. We toss them into our backpacks and keep moving forward. Some hikers would falter, but Melissa was built for this. She’d carried the stones of her family’s traumas uphill for years. She was strong. 
When men began to befriend and reject her, saying ‘you’re too good for me’ but not too good to make them feel good. She carried that. 
When childhood friends began to cut off the strings of her heart, saying ‘We can’t be friends anymore’. She carried that.
When her family separated like dandelion seeds, it seemed like they’d never be together again. Melissa slept on so many couches, floors and car seats sometimes she didn’t know if she’d see them again. 
She carried that. 
Dying was never an option though sometimes she didn’t mind the thought of it. Peace and warmth were two things she’d desperately yearned and hadn’t felt fully since the womb. Then one night in the pitch black of the hot, sweaty, roach-infested studio in southeast Houston she slept in she wondered:
‘Why can’t I break the rules?’ She’d seen everyone else in her life break them like popsicle sticks. And she didn’t just want to break the rules, she wanted to break them boldly and loudly and annoyingly and honestly and sloppily like every one else gets to do. It was in that moment, tucked in a thin jacket inside of an 8-foot high instrument cubby in the inky darkness—it hit her. 
‘Is my suffering for a high purpose? Or is my suffering trying to kill me?’ 
She cried. 
She escalated. 
She took it personal. 
But it wasn’t enough. She wanted to scream in a microphone in a sea of shadowy faces. She drank whiskey and wove her pain into rock music. 
‘Music is my boyfriend’ she declared. The only man that kept his baggage to hisself. And it healed her. It gave her voice reason and purpose. 
The pebble-laden hike became lighter with time. The incline eventually evened out to flat, beautiful landscapes where the breeze finally met her back. She knew it wasn’t gonna be easy or sunshine but even the rain cleansed her and it was beautiful too. 
Somewhere in the rain she decided rules were meant to be built and broken. Like trust and love and friendships and families. Because every thing deserves the opportunity to change and grow. 
So... She broke rule number 1 on stage while singing a beautiful song. Dr. Jefferson (PhD) screamed for her to stop but she didn’t listen and the tears flowed like rivers of emotion down her cheeks. 
Rule number 2 was broken when she grew older and saw the injustices of the world. Marching with hundreds in protest she realized not everything needs to be pacified. 
And one day when she finally fell in love, she broke rule number 3. No matter how much training she’d done she couldn't help but take every thing her lover said and did personal. But it was ok. Because in all her resistance she realized breaking rules was her power. 
Melissa began to fall for her feelings. Her feelings gave life purpose. They weren’t always logical, as feelings seldom are. They were sloppy and embarrassing and rude and so fucking uncomfortable. But they were hers. And they were real. And when she sat alone sipping wine, staring at the moon…They were the only ones still by her side. Ready to break the rules for her because they loved her. 
And she finally loved them back. 
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simandy · 10 months
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Commissioned by @konpeitogalaxy !
Coolest hairstyle ever by @konpeitogalaxy ! Thank you for allowing me to recreate your cool hair!
IMPORTANT NOTICE: I'm changing this hair's thumbnail and post image because the original commissioner asked me to :) Here's his open letter to simblr:
"hello :3 this is konpeitogalaxy! im sorry for causing a fuss, but as a trans masc person it took me off guard and made me very dysphoric to see hundreds of people exclusively tag a creation based off real life pictures of me exclusively as #female hair and #female sims and whatnot ^^* i understand i look very feminine because i can't start hrt due to finances and health, but as a favor to me, please use the cc i commissioned for more non-female characters as well as tagging it as both female *and* male hair (because it works on both frames which is super awesome!!) i understand if you only want to use my hair for feminine sims, but out of respect, please just tag it as #male cc as well as your other tags or something like that when youre sharing it around ^^* <3 thank you very very much for reading all this and i hope you have a beautiful delightful and lovely day :-)"
I hope everyone understands it! Have a nice day! ^^ Changing the post's picture was our shared decision so we could remind you of the different usages of the hair, as it fits all frames! Thank you!
BGC
For all frames!!
All Lods
Hat Chops
24 EA Colors
40 Puppy Crow Colors (You will need the mesh with the EA colors)
64 Root Overlay ADD-ONS located in HATS!
TOU
                           ⭐ • DOWNLOAD • 💗
PLEASE CONSIDER DONATING ON KO-FI OR BECOMING A PATRON. I’m trying to pay for my new ADHD meds, antidepressants and therapy, also college. Please, consider sharing too, if you can’t pay. Thank you for the support :)
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A Big TB Announcement
Greetings from Washington D.C., where I spent the morning meeting with senators before joining a panel that included TB survivor Shaka Brown, Dr. Phil LoBue of the CDC, and Dr. Atul Gawande of USAID. Dr. Gawande announced a major new project to bring truly comprehensive tuberculosis care to regions in Ethiopia and the Philippines. Over the next four years, this project can bring over $80,000,000 in new money to fight TB in these two high-burden countries.
Our family is committing an additional $1,000,000 a year to help fund the project in the Philippines, which has the fourth highest burden of tuberculosis globally.
Here’s how it breaks down: The Department of Health in the Philippines has made TB reduction a major priority and has provided $11,000,0000 per year in matching funds to go alongside $10,000,000 contributed by USAID and an additional $1,000,000 donated by us. This $22,000,000 per year will fund everything from X-Ray machines, medications, and GeneXpert tests to training and employing a huge surge of community health workers, nurses, and doctors who are calling themselves TB Warriors. In an area that includes nearly 3,000,000 people, these TB Warriors will screen for TB, identify cases, provide curative treatment, and offer preventative therapy to close contacts of the ill. We know this Search-Treat-Prevent model is the key to ending tuberculosis, but we hope this project will be both a beacon and a blueprint to show that It’s possible to radically reduce the burden of TB in communities quickly and permanently. It will also, we believe, save many, many lives.
I believe we can’t end TB without these kinds of public/private partnerships. After all, that’s how we ended smallpox and radically reduced the global burden of polio. It’s also how we’ve driven down death from malaria and HIV. For too long, TB hasn’t had the kind of government or private support needed to accelerate the fight against the disease, but I really hope that’s starting to change. I’m grateful to USAID for spearheading this project, and also to the Philippine Ministry of Health for showing such commitment and prioritizing TB.
One reason this project is even possible: Both the cost of diagnosis (through GeneXpert tests) and the cost of treatment with bedaquiline are far lower than they were a year ago, and that is due to public pressure campaigns, many of which were organized by nerdfighteria. I’m not asking you for money (yet); Hank and I will be funding this in partnership with a few people in nerdfighteria who are making major gifts. But I am asking you to continue pressuring the corporations that profit from the world’s poorest people to lower their prices. I’ve seen some of the budgets, and it’s absolutely jaw-dropping how many more tests and pills are available because of what you’ve done as a community.
I don’t yet have the details on which region of the Philippines we’ll be working in, but it will be an area that includes millions of people–perhaps as many as 3 million. And it will include urban, suburban, and rural areas to see the different responses needed to provide comprehensive care in different communities. This will not (to start!) be a nationwide campaign, because even though $80,000,000 is a lot of money, it’s not enough to fund comprehensive care in a nation as large as the Philippines. But we hope that it will serve as a model–to the nation, to the region, and to the world–of what’s possible. 
I’m really excited (and grateful) that our community gets to have a front-row seat to see the challenges and hopefully the successes of implementing comprehensive care. Just in the planning, this project has involved so many contributors–NGOs in the Philippines, global organizations like the Partners in Health community, USAID, the national Ministry of Health in the Philippines, and regional health authorities as well. There are a lot of partners here, but they’ve been working together extremely well over the last few months to plan for this project, which will start more or less immediately thanks to their incredibly hard work.
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