The man who gave away sixty million dollars
In 1993 a Colombian immunologist was offered sixty million dollars for a patent, and said turned it down to, instead, give it to the world.
His name was Manuel Elkin Patarroyo. He had spent years in a laboratory in Bogotá building something nobody had built before, a malaria vaccine assembled out of synthetic peptides rather than grown from the parasite itself. He called it SPf66. It was the first synthetic vaccine against malaria, and for a short and remarkable stretch of the early nineties it was one of the most valuable objects in tropical medicine.
A biochemical laboratory offered him sixty million dollars for the rights. He turned it down. On the 12th of May, 1993, he ceded the exploitation rights to the World Health Organization instead, and asked for one thing in return: that the vaccine be manufactured in Colombia, so the price would stay within reach of the people who actually needed it.
He gave away a fortune. On purpose, in public, with his name on it.
He inspired the character Elka in my book The Change.
The truth about the vaccine Dr. Patarroyo invented is that after a lot of testing, it did not work.
The large field trials came, and they were not kind. A Cochrane review later found no useful protection in Africa or Asia, and only a marginal effect in South America. The science moved on to other candidates, as science does. SPf66 is now a footnote. The fact that it failed was not what mattered to me.
So let me be plain about what I am not claiming. I am not claiming the vaccine worked, or that the sixty million dollars was a bad price for something that turned out not to work. On the narrow question of the asset, the buyer would have overpaid enormously.
What interests me is not the outcome. It is the decision, made at the moment when nobody yet knew the outcome.
Because on the 12th of May, 1993, Patarroyo did not know it would fail. Nobody did. Standing there he had every reason to believe he was holding the end of malaria in his hands, and he gave it away anyway. The choice has to be judged on what he knew when he made it, and what he knew was that he was probably signing away the largest sum of money he would ever be offered for the good of others.
I am also not calling all who sell a cure greedy or evil.
The argument for owning a cure is not, on its own, greed dressed up. I build businesses and I know that discovery is enormously expensive and fails far more often than it succeeds, and the only reliable engine anyone has built for funding the failures is the profit on the rare success. Exclusivity is what persuades capital to stand in front of a nine-in-ten chance of losing everything. Take it away and you do not get cheaper medicine, you get less medicine. And there is an uncomfortable second point, which is that SPf66 failed partly because it never had the disciplined, brutally expensive development process that a commercial owner would have forced on it.
I do not think that argument is wrong. I think it is true, and load-bearing, and I would not want to live in a world that ignored it.
But I have spent thirty years on the other side of this question, and it has taught me where the argument stops.
I build software. I have spent most of my career on subscription models, recurring revenue, priced by the month, renewing forever. I have stood in rooms and argued for it in front of people who took real convincing. I still believe in it today.
Here is why it works, and it is not the reason most people give. It is not the predictability of the revenue, though finance likes that. It is that the customer can leave.
A subscription is a verdict, delivered monthly or annually. If the product stops earning its price, the customer stops paying, and the vendor feels it immediately and precisely. That single fact is what keeps the model honest. Recurring revenue is not a way to stop selling; it is a commitment to keep selling, and keep supporting, every month, forever. The exit is not a flaw in the design. The exit is the design.
Take the exit away and you have not modified the model. You have inverted it.
And that is the question I could not put down. What happens to a business priced by the month when the thing being metered is not software but a human body? When the customer cannot switch, cannot defer, cannot go without, and cannot negotiate? Every mechanism that makes recurring revenue disciplined runs the other way. Price sensitivity becomes desperation. Retention becomes captivity. The renewal conversation, which in my world is a fair fight between two parties who both have options, becomes something else entirely, because only one side can walk out of the room.
I know how a plan like that would be received. It would not arrive as villainy. It would arrive as a competent executive with good slides, a defensible margin, a total addressable market and an unimpeachable duty to shareholders. Nobody in the room would need to be cruel. The model would do all of the work.
That question is what my novel turned out to be about, though I did not know it when I started.
The Change is set fifty years from now, and its premise is that anyone past the age of fourteen can fall asleep as one sex and wake as the other. But the engine of the book is not the sickness. It is two people racing toward the cause from opposite ends of the earth. One means to give the cure away for nothing. The other, heir to the fortune that quietly caused the whole thing, means to sell the world its only protection by the month, forever, and use it to build power.
I gave the first one a piece of Patarroyo’s name so that anyone who went looking would find him. She is not his descendant. She is his argument.
The book comes out on the 1st of October. I will leave it there, because this was never meant to be a sales pitch, and because the real story is better than the invented one.
Manuel Elkin Patarroyo died on the 9th of January, 2025, at the age of seventy-eight.
The vaccine failed. Him choosing empathy did not. And I would rather live among people who make that choice and are proven wrong than among people who lead with greed and lack all empathy.
Most of you reading this have never heard his name, which is precisely why I left a piece of him in the book. We know exactly who got rich in the nineties. I had to go looking to find the man who decided not to.