It’s that season again: time for the big reveal of the TIME 100 — our editors’ picks for the most influential and interesting people in the world. There are some boldface names on this year’s list you’ll recognize: Hillary Clinton, Adele, Louis CK, Stephen Colbert. But there are a bunch you probably won’t — people who are changing the world in huge ways, just not on TV or on a concert stage. Here are two of my favorites:
Ron Fouchier. The next big pandemic is just a viral mutation or two away — just ask Ron Fouchier, a virologist at Erasmus Medical Center in the Netherlands. In his lab, Fouchier managed to create a virulent strain of bird flu, or H5N1, that passed easily between infected and sneezing ferrets (the animals are a common lab stand-in for humans when scientists study flu). That’s scary because in the real world bird flu is highly lethal in humans, but doesn’t normally spread easily from person to person. Fouchier’s work was designed to help scientists better understand how H5N1 could mutate and how to try to control it if it does. Problem is, the study results haven’t been published yet because of concerns that the man-made strain could potentially be used as a bioterror weapon. That’s another thing that Fouchier’s work exposed: the thin line between good science and good science that can go bad.
Robert Grant. Treating HIV is one thing, but preventing infections to begin with is the ultimate goal. Robert Grant brought us one step closer to that target by championing the idea that two powerful life-saving antiretroviral (ARV) drugs, tenofovir and emtricitabine, which are currently used to treat HIV after a person becomes infected, could also protect healthy individuals from ever acquiring the virus, as long as they took the medications before they engaged in high-risk behaviors. Two trials showed that he was right:
The first set of results were promising. Men taking a daily dose of the tenofovir combined with emtricitabine cut their risk of HIV infection by 44%, compared with men taking a placebo. What’s more, the more faithfully the men took the drugs, the better their chances of avoiding infection; those who reported taking the medication 90% of the time were 73% less likely to become infected, compared with those taking placebo.
These groundbreaking results, published in 2010, were followed up by similar successes in other trials. Just this year, two studies involving some 6,000 heterosexual men and women — including couples in which one partner was HIV-positive and the other was not — found that when healthy, uninfected people took ARVs prophylactically for up to three years, they cut their risk of HIV infection by 63% to 73%.
Grant was championing this concept — called PrEP, for pre-exposure prophylaxis — long before it was popular. Critics said it was foolish at first: why would you give such potent drugs to healthy, uninfected people? But AIDS researchers have come around because PrEP works, and for now, it’s as close as we’ve got to the elusive, ultimate goal: a true AIDS vaccine.