Here’s something strange about how we keep score.
When a problem is bad, it is everywhere. It is on the news every night, it is in the magazines, people argue about it at dinner. Then somebody actually fixes it, and the coverage stops. Not slowly. It just stops, because a solved problem isn’t a story anymore.
So the fixing never registers. We remember the crisis at full volume and the solution not at all.
Which means most of us are walking around with a running tally of everything humanity has failed at and almost nothing on the other side of the ledger.
I went and found the other side of the ledger. Here are five problems that used to be considered permanent features of the world, all of which were largely solved while nobody was covering it.
1. A disease that infected 3.5 million people a year is down to ten cases
Guinea worm disease is about as bad as it sounds. There is no vaccine for it. There is no drug that cures it.
In 1986 there were roughly 3.5 million cases a year across 21 countries in Africa and Asia.
In 2025 there were ten.
Not ten thousand. Ten people. Four in Chad, four in Ethiopia, two in South Sudan. That is a reduction of more than 99.99 percent, and the campaign has prevented well over 100 million cases along the way.
Now here is the part that should stop you. They did it without a vaccine and without a medicine. There was no scientific breakthrough to wait for.
They did it with water filters, education, and relentless, boring, village-by-village surveillance. Somebody had to go find every single case, teach every community how the parasite spreads, and then keep doing it for forty years across some of the hardest terrain and most unstable regions on earth.
Two hundred countries are now certified free of it. Six are not yet.
Adam Weiss, who runs the eradication program at the Carter Center, said something about the end game that I think about a lot. Every case is a real person they know by name. And zero is the only acceptable number.
When they get there, guinea worm will be the second human disease in history ever deliberately wiped off the planet, after smallpox. And it will have been done with education and filters.
2. We took lead out of gasoline everywhere on earth
We started putting lead in gasoline in 1922. For most of a century, every car on the road sprayed a neurotoxin into the air of every city on the planet. It got into the soil, the water, the food, and into the blood of basically everybody alive.
Lead damages developing brains. There is no safe level of it in a child.
Wealthy countries mostly phased it out in the 1980s. Everywhere else kept going. UNEP launched a formal campaign in 2002 to finish the job worldwide, and it took them almost twenty years.
In July 2021, Algeria burned through the last of its supply. And with that, the era of leaded gasoline on planet Earth was over.
The estimated payoff: more than 1.2 million premature deaths prevented every year, an IQ gain of 5 to 10 points for children in the affected countries, and around $2.45 trillion a year in economic benefit.
I want to sit on that IQ number for a second, because it is easy to skim past. Somewhere right now there are kids growing up sharper than they otherwise would have been, and none of them will ever know it, and none of their parents will ever know it. There is no ceremony for that. It just quietly happened, and it happened because a bunch of people spent two decades on a deeply unglamorous regulatory grind.
That was one of the largest public health wins in human history and it got maybe a day of news coverage.
3. The ozone hole is closing, and it is closing early
If you’re over forty you remember when the hole in the ozone layer was the scariest thing anybody could name. It was the environmental catastrophe of the 1980s.
In 1987 the world signed the Montreal Protocol and started phasing out the chemicals doing the damage, the ones in refrigerators, air conditioners, firefighting foam and hairspray.
Here is where that stands now.
The 2025 ozone hole was the fifth smallest since 1992, and the smallest in five years. It was roughly 30 percent smaller than the record hole in 2006. It closed on December 1, the earliest closing since 2019, breaking up nearly three weeks ahead of the average for the last decade.
NASA scientist Paul Newman gave the cleanest possible measure of the win: this year’s hole would have been more than a million square miles larger if there were still as much chlorine up there as there was 25 years ago.
If current policies hold, the ozone layer is projected to return to 1980 levels around 2040 for most of the world, about 2045 over the Arctic, and around 2066 over Antarctica.
The Montreal Protocol is the only UN treaty ever ratified by every single country on earth. And as a bonus nobody planned, the chemicals it banned were also powerful greenhouse gases, so phasing them out is expected to spare us roughly half a degree Celsius of warming.
We were told this one was going to get us. Then we fixed it, and stopped mentioning it.
4. Teen cigarette smoking in America has essentially collapsed
In 2025, the share of American high school students who smoke cigarettes was 1.8 percent.
One point eight.
If you went to high school in the 1990s, go read that number again and then go picture your own parking lot. It was normal. It was most of a generation. Tobacco companies had built an entire machine aimed directly at fifteen-year-olds and it worked for decades.
The people running that fight took on the most profitable, most politically protected industry in the country and they won on the ground that mattered most, which was the next generation.
Now, I said I’d give you the honest version, so here it is. This one is not clean.
Over 2 million middle and high school students still use some tobacco product. About 1.4 million kids used e-cigarettes in 2025, more than 40 percent of them frequently, and that number did not drop from the year before. Nicotine pouch use among high schoolers has been climbing since 2022. And roughly 90 percent of the kids using either one are using flavored versions, which tells you exactly who those flavors are for.
So this is a real win with a real asterisk. The cigarette is nearly beaten. Nicotine found another door.
But 1.8 percent is still one of the great public health achievements of my lifetime, and it happened without most people noticing the fight was even being won.
5. A child born today is less than half as likely to die as one born in 1990
In 1990, 1 in 11 children died before their fifth birthday.
In 2024, it was 1 in 27.
The global under-five mortality rate fell about 60 percent, from 93.5 deaths per 1,000 births down to 37.4. That works out to more than 5.5 million children a year who are alive who would have died at 1990 rates.
Five and a half million. Every year. That is not a program or a policy, that is a number of actual children, and it happened in a single generation.
There was no one thing that did it. Vaccines. Clean water. Bed nets. Better care around birth. Oral rehydration salts, which cost pennies. Thousands of unrelated efforts by people who never met, all pushing the same number down.
And again, the honest version. 4.9 million children still died before age five in 2024, which is about 13,300 a day. Sub-Saharan Africa still carries 60 percent of it. And the rate of improvement has slowed badly, from 3.9 percent a year between 2000 and 2015 down to 1.5 percent since.
So this is not finished and the slowdown is a warning, not a footnote. But if you want to know whether human effort actually moves anything, there is your answer, in the plainest terms there are.
What these five have in common
I looked for the pattern, and there are four things true of every single one.
None of them had a silver bullet. No miracle cure, no single invention that ended it. Guinea worm was beaten with filters and conversations. Child mortality fell on a thousand small fronts at once. The dramatic breakthrough almost never shows up. The grind does.
Every one took decades. Montreal Protocol signed in 1987, still working on it in 2066. Guinea worm, forty years and counting. Leaded gasoline, nearly twenty years just for the last stretch. Every person who started these was signing up for work they would not see finished.
Every one was called impossible by serious people. Eradicate a parasite with no vaccine, across war zones? Get every country on earth to sign the same treaty? Beat the tobacco industry? All of those were considered naive when somebody first proposed them.
And the reward for solving it was that everyone forgot it existed. That’s the cruel joke, and I think it’s the most important part. The better you fix something, the less anybody remembers it was ever broken. Which is exactly why so many good people believe nothing ever works.
The part I keep thinking about
We are all living inside the results of problems that our parents and grandparents refused to accept.
You are breathing air that somebody cleaned up. Your kids have brains that somebody protected. A lot of people you know are alive because of a fight that was won before they were born, by people whose names they will never learn.
Nobody threw those people a parade. Most of them died before the win was official.
And somebody is going to live inside the results of what we do now, and they won’t know our names either.
I’m not saying that to be heavy. I’m saying it because I think it reframes what a life’s work actually is. The pattern says the wins are slow, unglamorous, and only obvious in the rearview mirror. It says the people who move things are the ones who kept going on something that a lot of smart people told them was hopeless.
That is available to you. It is available on whatever scale you’ve got. A company, a neighborhood, a family, one kid.
The world is not stuck. It has never been stuck. It just fixes things slowly enough that you have to actually go looking to notice.
Go pick something and start grinding on it. That is how every one of these five got done.
Let’s go.
Phil
Sources: The Carter Center on Guinea worm eradication · UNEP on the end of leaded petrol · World Meteorological Organization on the 2025 ozone hole · Campaign for Tobacco-Free Kids on the 2025 National Youth Tobacco Survey · UNICEF and the UN IGME on under-five mortality.
