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MALE SPEAKER: I'm going to have the distinct pleasure of

introducing Paul Epstein to you.

But before I do that, let me just say that, as I think all

of you know, is involved in three areas: the

global climate crisis, global health, and global poverty.

These are very iterative things.

As people emerge from poverty, as they have in China, they

use more electricity.

As they use more electricity, the energy thus consumed

creates more carbon.

As that carbon goes into the atmosphere temperature rises.

As the temperatures rise those places that are amongst the

poorest in the world get inundated with water.

So if the climate crisis continues, China has

remarkably taken 300 million people out of poverty and

thrust them into the middle class.

Unfortunately, there's another 300 million standing in line

behind them.

And another 300 million behind them.

If they all go in the same way, consuming the same amount

of energy, Bangladesh will be underwater and there will be a

100 million Muslim Bangladeshis who become

refugees in Hindu India and in China.

And the same thing is true with the relationship between

health and climate.

Places in Africa that were established at 6,000 feet

because anopheles mosquito, which carries malaria,

couldn't go to that height; now they

can go to that height.

So you're seeing a total interaction between the

climate change, between global health, and poverty.

Each feeding the other.

I am so pleased that Paul is here today.

Paul and I have known each other for, I won't tell you

how long, but Paul and Fitz Mullen who's over here, who is

at George Washington.

Fitsu Seamus McManus Mullen.

The three of us were all interns together back in 1969.

That's how far back we go.

And Paul now is at the epicenter of all the things

that does.

He is the head of, or the Associate Director, of the

Center for Health and Global Environment at Harvard.

He is working on the interface between climate and health.

He lived in Mozambique for a long time, speaks Portuguese,

travels back and forth to Africa, has worked with

Brazilian immigrants in Boston, is a physician, is an

epidemiologist, has a master's in public health, and is one

of the most widely respected people in the world at the

interface between the climate crisis and global health.

So please join me in welcoming Paul Epstein.

PAUL EPSTEIN: Well, thank you Larry.

It is a great pleasure to be with Larry, and Fitz,

and with you all.

I was going to start with 1996, when we started our

center, but because of this confluence I'm going to start

in 1854, just for a second.

Where Rudolph Virchow, who's a physician and a surgeon, took

to the streets as an activist and said cholera,

smallpox, TB in London.

You know the story of John Snow, but behind it there were

some physicians.

Medical people, nurses I'm sure, who we're talking about

the social, and economic, and environmental

determinants of health.

And that helped create this whole movement, which actually

led to a leveling off of those diseases.

So that's the good news about an intervention.

Back in the 60's, we were active in the student health

organization, medical community for human rights,

and I could go on and on about our work.

But I do this introduction because our center was founded

by myself and Eric Chivian, who came from the

International Physicians for Prevention of Nuclear War.

And the IPPNW, Physicians for Social Responsibility, had the

position that the health consequences of nuclear war

could help turn public opinion, policymakers opinion.

And that played a strong role.

They got the Nobel peace prize for that work, to

stop nuclear testing.

Later with the Montreal protocol and stratospheric

ozone depleting chemicals, physicians also played a role.

Dermatologists, immunologists, spoke about the health


All that is to say that we've started this center at Harvard

medical school to look at the health consequences of global

environmental change, biodiversity climate change,

as a way of communicating the direct issues that have come

to our backyard.

It's not just about ice, polar bears, it's

also about our health.

And, since we are waiting, our center is founded on three

pillars we do education primarily for medical

students, but we draw from the School of Public Health at

Harvard, Divinity School, Business School, Kennedy's

Government School, Tufts Fletcher

School journalism students.

And that is on the web, broadcast free as you do

things, to 65 medical schools and some overseas.

We also do education for policy makers in D.C. We do a

two-day course for legislative aides and give them a

convinced view of this course.

And we do briefings on climate and health and agriculture.

Climate and health and marine systems.

Finally we do research on climate change and

biodiversity and we've done a number of experiments with

folks at Harvard.

And so I won't go on about that, but that's our center

and we're celebrating our tenth year.

This year we had a global environmental citizens award,

and last year was Al Gore who got our

award from Meryl Streep.

So that's our claim to fame.

Ok, I'm going to talk about something in three parts.

And I'm going to try to talk pretty fast so we can have a


Climate basics, climate and health, and then talk about

solutions, and how we can think about health in terms of

which energy solutions we need to adopt.

Back in 1991, there was an outbreak of cholera in Peru.

So those are algal blooms. Galapagos are about 500

kilometers off.

Turned out that warm sea surface temperatures, and

extreme events, which flush a lot of nutrients into the

environment, helped create these algal blooms. They were

initis for cholera.

That was the work of Rita Colwell who later went on to

run the National Science Foundation.

And so the cholera came in three different places.

And those connections between climate, environment, and

disease began to be made.

We went to the Rio summit in 1992, I was telling Larry, we

presented this.

People said what are you doing here?

Physicians, medical people, this has nothing to do with

the environment.

Well, no one got this.

No journal published it, except one journal.

The Wall Street Journal.

Shrimp exports, tourism.

And so this is a theme that carries me through this work.

That leads to our report, which I will tell

you about in a moment.

Of health, ecological, and economic

dimensions of climate change.

And indeed, this is a way of looking at the results, the

downstream consequences of the upstream

conditions and causes.

And the downstream costs that can help think about

development, as well as health and climate, and how energy is

key to all of those.


This much we know is true.

The Intergovernmental Panel on Climate Change's third

assessment report was five years ago.

Climate is changing, humans are contributing, biological

systems are responding on all continents, and in the oceans.

And the weather is becoming more extreme.

So that's five years ago.

Since 2001 we've learned a great deal more.

Carbon dioxide is now up to 380 parts per million in the


What this is, is an ice core record that was back to

420,000 now its back to 750,000.

Probably 2 million years ago, when the Panama isthmus closed

off and the gulf stream started, we started isolating

between large ice caps and medium size ice caps.

Between 288 and 180, reverse that, 180 was the ice age, the

large ice cap.

We are now outside that envelope that we've been in,

probably for 2 million, perhaps back to the dinosaurs

and 65 million.

We are pushing the envelope, as it were, on the feedback

mechanisms, the ocean sink, the land sink, that has helped

stabilize climate for 2 million years.

Clearly for the last 10,000 years, that's our holocene

that's been so hospitable.

So hold on to your holocene is our cry.

Hold onto your hats!

We are pushing this.

And I must say this cycle of earth around the sun, and its

tilt, and its wobbles, and eccentricities is what has

driven these cycles.

The latest calculations are that we were not about to come

out of this holocene anytime soon.

So we really are changing what was the trajectory.

Polar and mountain glacial ice melt is accelerating.

Ocean temperatures are changing.

And winds around both polls are becoming more forceful.

That's probably the scariest thing I'll say.

What's happening with the ice?

This is a slide which shows you the difference in the melt

during summer over this ten years.

What we're now seeing is an acceleration.

Some of these outlet glaciers are melting at 14

kilometers a year.

Eight or nine miles a year.

Five years ago they were going at seven miles, seven

kilometers per year.

We're seeing now melt of Greenland ice three times what

it was between the 1997 and 2003 period.

It's 250 cubic kilometers and was 80.

So we're seeing rates of change change.

These are derivatives.

This tells us something about systems.

And so, just to look at systems for a moment.

This is the kind of issues that now the IPCC and

scientists are dealing with.

It's not just numbers of 380 parts per

million or 450 or 550.

We're talking about rates of change, volatility, novel

events, anomalies, and changes in multiple components.

Because it's really the bathysphere the cryosphere

that's the ice, it's the biosphere, the atmosphere, the

stratosphere, that we are playing with here.

And that means that if we all sat around this table and

pushed it is more apt to go over.

So we're looking at how we look at change.

Change can be abrupt.

It could be stepwise.

We look at also in this report, this climate change

futures report, that we did with Swiss Reinsurance Company

and the UN development program.

Look at impacts and how they can change abruptly.

And this is perhaps the main contribution of this kind of

thinking about forest, about our health, about marine life.

OK, a couple more on this climate stuff.

This is the pictorial of what's happening to the

tropical oceans.

They're becoming warmer and saltier, because warm water


And up north, because of all that melting and rain falling

at high latitudes, we're seeing cooling and freshening.

Now there's a pump up there.

When it's cold and salty, as it's been, it sinks and that

pulley system pulls up the gulf stream and that sets in

motion this conveyor belt that has helped stabilize climate

for this 10 thousand years.

And during these periods of change we see a change in that

conveyor belt.

What's happening now is that because of that freshening,

it's layering across.

And we're seeing a slowing down of that pump.

That circle that you see is the gulf stream coming up and

going around.

It's the same as the trade winds that brought rum this

way and slaves this way, and the whole triangular trade

from our 12th grade.

That was driven by the trade winds that drives the oceans.

We are seeing a 30% decrease.

That's the kind of projections that were made for 2100.

We're seeing storms, like Katrina, that are the kind of

storms we were projecting for about 2080.

We are seeing changes that we projected later on in the

century happening today.

And thank goodness we had a very nice calm season.

And we in the public are giving out a sigh of relief,

as are the insurance companies.

Here's what happened about 12 thousand years ago.

There was so much warming and melting that the gulf stream

shot straight across to Europe, the ice returned for

about 1,300 years.

That's the day after tomorrow scenario.

It's the pentagon scenario.

It's the National Academicy of Sciences abrupt climate change

inevitable surprises.

All of which led to that movie and that scenario.

Can this happen?

Well, it can.

And I guess the most positive scenario I want to remember to

give you is that maybe this will shut down but we've had

so much warming that we're not headed towards an ice age.

So that's my comforting word for you.

All right.

What does this mean for bottom lines?

And we're going to come to health in a moment.

For the financial world, we see a change in the

catastrophic weather events and these are primarily those,

this is from the IPCC and its in small letters, but mostly

weather related events.

We saw a change of one order of magnitude from

the 80's to the 90's.

In the last two years we've seen another stepwise jump,

about a half a log.

This has been enormous for the insurance world.

They've seen this stepwise function again, and indeed

insured losses go up about 200 fold because of all the storms

in Europe, the US, and Japan.

So we've seen a shift actually in extremes from Mozambique,

Honduras, Venezuela in the 90's.

And now more extremes occurring in the north because

of all of these changes in the north Atlantic.

So we can tie this to climate in a really

plausible dynamic way.

Were all those losses due to climate change?

Well yes, we're living near the coast and the Gulf.

Yes, real estate prices are up.

Yes, insurance penetration is up.

And, and, and that's the key word.

There are more extreme events, more different kinds of

extreme events.

So it's not an either/or issue.

Climate change is playing a role as there are economic

vulnerabilities as well.

Let's look at Katrina, Rita, Wilma, this whole

episode for a moment.

The lake was having waves come across that were much higher

than the levees.

As we look to rebuild these levees, we're in a quandary,

because the power of this storm was

greater than the levees.

Those coming off the gulf were much higher than the oil rigs.

And knocked a lot of the oil rigs.

They're still 25% down in terms of oil

and gas in the Gulf.

Think vulnerability in the energy sector.

Between the refineries, the pipelines, the oil rigs,

they're still down.

Life and health, property and casualty, forgive me this is

insurance speak, but these are the folks that I'm working

with now to talk about the implications of all this.

But we're seeing a new disease occur.

Katrina cough.

You've seen people with masks.


Oil spill the size of the Exxon Valdez.

11 million gallons.

Were not even thinking about this but it's in the wetlands.

It's a mess.

And mold.

Floods foster fungi, one of our mantras.

Food security was affected circuitously.

It was sent from southern Africa to Asia, but it got

hung up on the barges in Mississippi.

Energy prices and political instability.

And I'm not a betting man, but I would bet that the price at

the gas stations will go up in about a month,

if you get my drift.

And we've seen changes for many countries and, just as in

the 70's when oil went from $3--

I don't know if you did get my drift, but I think that

there's been manipulation of the oil prices that has been

in the New York Times editorial, I'll quote.

And whether that will change after the elections we don't

know but, it's a possibility.

I don't want to give any hidden messages.

It's all out.


So in the 70's, the oil crisis.

$3 to $30 it went in several years.

Gold went from $38 to $600.

That probably bought the apartheid regime about 15

years longer than it would have had because of the price

of gold, and they were such a source of gold.

Well it destabilized many countries.

There is a wonderful movie, Life and Debt.

If you haven't seen it, I recommend.

That talks about that period and the debt that

began in the 70's.

Led to the petrol dollars in investments, and then

inflation in the 80's, and speculation

specu-dollars in the 90's.

It all started with that loosening of Bretton Woods

rules, and we can come back to that in a moment.

But the price of oil had a lot to do with the instability,

and failed, and fragile nations, that we face today.

It has our image and it certainly will affect our

politics, if not this election, next election.

But clearly energy and climate are key to our development and

our healthy development.

If there is one number that I want to leave with you, in

this talk, is 22.

This is work about the heat in the oceans as compared to the


Done by folks at your Department of Commerce, see

Leviticus, et al.

NOAA National Oceanic and Atmospheric Administration.

Tim Barnett, out here at the La Jolla and Scripps.

What they found was that the heat in the atmosphere is

dwarfed by the heat that's accumulated in the deep ocean.

This is central to this understanding of the changes

of the heat budget of this globe.

Water is warming.

Ice is melting.

Water vapor is rising.

A hydrological water cycle is accelerating.

It is affecting land areas in terms of greater evaporation

and more intense droughts.

It's also getting more water vapor hanging up there, and

when it does cool and condense it comes

down in dumps, downpours.

Which is lovely in Saint John in the afternoon, but not so

good in California.

And it's also what contributes to more precipitation falling

during the winter as rain and snow,

because of the warm winters.

And you are well aware of the issues of snow pack your

closed mountains here.

So this is what's key.

It's the jules, the heat in the deep ocean, that is

driving the changes in weather.

And this is what's central to understanding the dynamics

behind the storms, the droughts, heavy

rains, and so on.

OK, health issues.

And please, throw your hand up at any point if there's

something you need clarification on.

Malaria is clearly one of the key health issues, and I don't

mean to belabor this, but we've looked at the economic

dimensions, as well as the human cost, and so on.

And clearly needs interventions in terms of

defense, public health, as well as how we look upstream.

This is what Larry alluded to.

What we're seeing is a change in the mountains, in Africa,

and Asia, and Latin America, where glaciers are receding,

plants are migrating up.

We're seeing that in the Alps as well.

We're seeing it in the Sierra Nevadas here.

And mosquitoes are circulating at high altitude, so Nairobi,

which is a mile high city, now has malaria circulating in it.

And we're seeing this in Colombia with Aedes aegypti,

was seeing in Papua New Guinea, we seeing it in Nepal.

And this serves as a consistent picture of this

change in the isotherm and permafrost, that we're also

seeing in terms of latitude.

These are some projections with Lyme disease.

Lyme disease is a complex disease that you don't have on

this coast because of a lizard that has an anti-

to it, as it were.

So there's biological diversity issues.

There are deer, and lots of mice, and few

predators of deer.

So there are ecological issues.

There are social issues, we're living in suburbs and sprawl.

Warming is also changing the latitude in which these ticks

can circulate.

So there's the projections with the computer of what can

happen over this century in terms of the expansion of the

area conducive to circulation of Lyme.

And this is an issue in Europe, it's an issue in the

midwest. And we've seen this year, I don't know about here,

but we are full of squirrels, and full of acorns.

It's a mast year.

It's driven by climate signals.

At any rate this is a big year for ticks.

So there are a number of reasons, but warming allows

the over-wintering of these ticks.

Asthma is an issue that in medical school we learned was

socioeconomic, perhaps some allergies, indoor pollutants.

There's a whole range of issues, of air quality issues,

under the radar that are all related to fossil fuel


Why don't you just look at that for a moment.

I'm not going to go through all these issues in detail.

Ozone, you're well aware of.

A study in LA showing that that could start, initiate

asthma, not just make it worse.

Floods and fungi, mentioned in the gulf coast, and so on.

What I want to call your attention to is this tree and

weed pollen.

We did experiments in greenhouses with ragweed.

Double the CO2.

So this is, forget climate change for a moment, global

warming, all those conclusions, just CO2.

There have been a number of skeptics that said that will

green the planet.

It's going to help agricultural, help forests,

take it up.

Well, what we hadn't forseen is that the

weeds love this stuff.

This is a perturbation, a stress for them.

And they like to put this carbon dioxide into there

pollen, which is their male part, territorial seeking

part, to spread their wings.

This is happening with poison ivy.

Poison ivy is getting a boost from carbon dioxide and

getting more toxic.

So if you've noticed poison ivy, you can blame it on

climate, and carbon dioxide, and burning fossil fuels.

We're seeing this with agricultural weeds, we're

seeing it with some soil fungi.

And this, of course, is a major source of illness.

It's the sixth leading cause of chronic disease in the US.

There's is CO2 dome under the cities that mirrors the heat

island effect.

I put this up here because it also

begins to look at solutions.

So its seven degrees greater, CO2 gets trapped in Phoenix,

in LA for sure, in New York.

And so there are issues of abandoned lots,

and ragweed, etc...

But this also points toward solutions, of green

building's, rooftop gardens, tree lined streets, pedestrian

and bicycle paths, smart growth.

All of these issues are good for our health in the inner

city, in terms of diesel and so on, that it actually helps

deliver these air allergens, so there are synergies.

But it also begins to drive the markets for these energy

efficient and alternative energy technologies.

Dust storms from Africa, and I'm winding down on health

issues here, but dust storms the size of the US are coming

across each year they deliver dust, they deliver some fungi

to the fan coral.

Kids in the Caribbean, kids in Florida, are getting asthma at

rates of 25%, that used to be less than 1% on

some of these islands.

Global change.

Over grazing, drought in Africa, some of which is

climate related.

There has really been a drought in sub-Saharan Africa

since 1965.

These are enormous, vast changes that also affect us

from China.

We're seeing dust come to your coast, and affect air quality

in California and in Denver.

I don't know if it's making it over the Rockies.


One of the issues was heat waves, clearly.

This 2003 was a major out-lier, six standard

deviations from the norm.

Lots of deaths.

Lots of issues for the environment,

for crops, for livestock.

Nuclear plant shutdowns.

And we'll come back to that as we come to solutions.

Alpine glaciers lost 10%, they've been losing about

0.7%, so this is not just an event that's a blip on

someone's chart, it's something that lives on in the

history of the lakes, in the water, for Switzerland.

Wildfires are clearly something we're seeing here

today, so I guess we should talk about this.

But clearly, arson is the speak but

we're seeing more wildfires.

More areas that are fire prone because of warming, because of

low snow pack, and so on.

One of the hidden issues is the bark beetles.

And you have them right here, this is mentioned in the New

York Times piece about this the other day.

And, before I forget the New York Times today has a major

article by Andy Rifkin about all the solutions

that I will come to.

But here we are back with the bark beetles.

And as we think about health, we're thinking about the

health of wildlife, livestock, forest, agricultural systems,

marine life.

Here's a pest, here's the agent, here's the host, here's

the environment.

If you're familiar with that epidemiological triangle.

But the hosts are getting emboldened.

They go on to higher altitudes, higher latitudes,

over-wintering, sneaking in a next generation each year.

The hosts are getting weaker by this alternating drought

and heavy rains.

Drought dries the resin in the bark that drowns the beatles

as they try to drive through the bark.

So the hosts are affected by the extremes.

The pest is affected by warming.

Those are the two parts of climate change, warming and

more extremes.

And here we are with fires, with the injury respiratory

disease, et cetera.

And a carbon pulse, this is the Kenai Peninsula.

So this is from Arizona, through California, up through

Vancouver, to Alaska.

This is an issue.

And on the east coast we are facing Woolly Adelgid, that's

affecting the hemlock trees.

Lovely trees where the moose breed and

lie during the winter.

These are their umbrellas.

And in the midwest there is an ash tree.

We're seeing this in Europe.

This is more and more an issue for our habitat and

assets, as it were.

But right now, before we think about money, just to our

habitat that is also being affected.

And I should say that this battle between insects and

trees is much older than the battle between malaria, and

dengue fever, and us.

This is about 325 million years when the trees started

growing on the earth.

The insects started rebounding, the trees started

to defend themselves with chemicals like cyanide, and

bark, and then birds came along.

That was the carboniferous period when all the fossil

fuels were buried, because of the dying of the trees, and

the battle with the insects, that was

fortunately won by the trees.

But what I'm hinting at here is that this battle may be

more crucial for our livelihood, our public health,

and underline our oxygen and water sheds.

This is something Al Gore siezed upon when he came to

visit us, and looked at this destabilization of the battle

between insects and plants, microorganisms and us, and so

on, that climate change is contributing to.


To end this part about health, with the next couple of

extreme weather events.

This is just a mapping exercise we did with extremes

in floods and droughts where hantavirus, dengue fever and

malaria, this was in Science in '99.

This will be all on the web.

If we look at oil and its life cycle cost, we look at

refining, extraction, exploration, and transport,

and clearly there are developing nation


But as we saw, no nation is immune.

And this isn't just for Mozambique the floods of 2000

where malaria spiked five fold.

So again, extremes may be more crucial

than the warming itself.

And for us variability, freeze-thaw cycle well that's

important in terms of migration of birds

that carry avian flu.

We can talk about that, but allergies we saw last January

in DC and New York people were starting to have itchy eyes

around January.

And maple syrup was flowing, so food security, Lester Brown

is concerned about these mismatches of

pollinators, and so on.

And so finally, these are two slides to summarize this

climate change futures study with Swiss Reinsurance, that

insures the insurers and the UNDP.

Looking across some of the costs again.

Asthma, fourfold increase in the US since 1980 and in many

developing and underdeveloped nations.

Then we stepped to the other side and looked at the

extremes, the floods and the droughts, and how they might

lead to clustering of rodent-borne, waterborne, and

insect-borne disease.

And then here was the central part that linked us to

industry because we looked at these diseases, pests and

diseases, of these natural systems. And I won't belabor

all of this, and this is on the web, but just call your

attention to coral reefs.

$800 Billion is what the estimate is per year of the

goods and services.

We're talking livelihoods, fisheries, hotels, that are

buffered on tourism and so on.

26% are lost because of warming, bleaching and

disease, over-harvesting, and nutrients.

These are multi-causality.

But warming is clearly what could knock this off.

And this is the kind of abrupt change in impacts for forest

and marine life that actually contributed

to the Stern Review.

If you look at any paper today, I think you'll see a

report of the Stern Review, which is advising Tony Blair.

And we briefed them.

They are looking at the cost of inaction.

They estimate it could be up to 20% of the global economy,

as opposed to 1% if we tackle the clean energy transition.

And they were looking again at the potential for abrupt

changes in impacts.


This is the last, the energy sector, just to say that it is

also vulnerable.

We mentioned the Gulf, there are also black-outs and heat

waves, cooling water.

They want to drill in Anwar, in Alaska, while the pipelines

are really fragile.

They're getting undermined by the melting that's affecting

communities, and livelihoods, and alcoholism, and all the

rest of the stuff that's in the arctic climate impact

assessment, I mentioned to you.

Lightening and warming.

We learned from the Hartford Boiler Inspection and

Insurance Company that warming actually makes more lightning,

so wild fires again.

And then of course feedback, so this is a major one in

terms of firewood being used for the energy for indoor

cooking and health, all the health issues related to that.

And the deforestation and carbon sink.

And now in Peru, their planning for some new coal

fired plants because they're losing their glaciers and


Alright, lots of bad news.

My friend Richard Clapp, who I know Fitz knows, you should

subtitle this talk, it's worse than you think.

So let me go to some solutions here.

I do believe that there is a confluence of forces that are

going to lead us to deal with this and a

convergence of agendas.

Climate instability we've talked about.

Peak oil is the other thing that you're hearing about.

It may not have peaked, but it will peak.

This is finite.

It's a finite resource.

And limits to growth may have been 30 years ahead of its

time, in the 60's, or 40, but there are limits to these

finite resources.

Energy sector vulnerability.

Environment we talked about.

We could talk about the Nigerian Delta, and all of the

issues of the environment.

Here are all these conflicts that one could tie to oil.

And I must remind us that even our president has said we're

addicted to oil.

So I like to say that's the first, of

a twelve step program.

Alright, these are the levels of response.

And for public health, we look at defence, and bed nets, and

treatment, and malaria, treatment, and

medicines, and so on.

These are the public health defense.

We also look in public health and how we can have

adaptation, whether there are early warning systems, using

El Nino forecasting, or climate, and so on.

How deforestation makes you more vulnerable to

floods, and so on.

And then we look upstream.

The real upstream.

We can look at the energy system as one of the key,

first, not sufficient, but necessary steps toward clean

development, and sustainable development.

Here is one of the ways that we're thinking about

solutions, is this wedges effect.

This was the work of Pacala and Socolow.

And actually Andy Revkin's piece today talks about this.

How do we bend the curve of the carbon emissions.

By 2050, how do we not produce gigatons of a billion tons?

How do we get 7 billion tons less, stabilize the


So we actually have to stabilize the emissions to

stabilize the concentrations.

But this is a first pass at seven kinds of solutions.

Alright, here's the 15 that are put forward in this

science piece by these Princeton folks.

And I'm just going to put this up here and give you a sense

of how we in public health, and ecology, and economics,

might begin to think about this.

And this is something that I've taken to city group asset

management, and Moody's and Standard and Poors and talk

about, where do you put your money now?

And that's true for Google as well.

How do we think about the health

dimensions and solutions?

Here we are at the rating system.

And I'm putting this up in a group, cafe standards.

Doubling them, 30 to 60 miles per gallon.

We could have plug-in hybrids.

You're all moving toward that here, faster than anybody.

Demand side management, and how we look at efficiency.

We use twice as much energy as Japan and

Europe for all we do.

Green buildings, and so on.

Well, citing is an issue.

How we do that, that you are very aware of.

PV, well that's clearly, it's all solar ultimately, that's

where all the energy comes, that's clearly solar

thermal, and so on.

Forest management I won't say, but nurturing

conservation tillage--

well, we've already got seven here.

If we move ahead we'd begin to really approach this model.

Then we've got a whole bunch that are fossil-fuel based,

carbon capture, hydrogen fuel cells.

We've got to study these.

We can put a lot into the ones with no regret, but we need a

lot of R and D for the others.

And then nuclear fission.

I'm just going to put three S's on.

Oh good, go ahead.


PAUL EPSTEIN: It's a life-cycle analysis.

So just as for oil, exploration, extraction,

refining, transport, and then combustion.

All of which lead to problems for public health and the


For nuclear, this is very apropos.

We can look at the life-cycle, from the mining, and the

dangers there, from the transport, and that's what the

Germans are on the road, trying to protest, and so on.

And then you come to milling, and then you come to the

plants, and the use.

And then you come to the storage.

And the storage, you all know Yucca Mountain, we've been

studying it for years.

$60 billion, we haven't solved it.

In order to make one wedge from nuclear, we would need a

new Yucca Mountain every three and a half years.

We haven't solved one.

The French haven't solved it.

The Swedes think they might have found a clay place to

tuck their stuff.

I actually talked before the Nuclear Regulatory Commission

a week ago, and until this slide they were all with me,

and then it was like, who let this person in?

It was like a [INAUDIBLE].

So three S's, storage, safety, and security is

clearly a big issue.

In England--

anyway, we have multiple problems that--

I was going to mention sea-level rise, because all

the nuclear plants are on the coast there, and the insurance

world is worried about that.

At any rate I think that these are issues that we're all

going to have on the table.

But I just came from the SRI, Socially Responsible

Investment group in the Rockies, there too there's

people questioning whether we should do nuclear.

I think from a health perspective, environmental

perspective, we have to take a strong position that this is


we should not replace carbon pollution

with radiation pollution.


PAUL EPSTEIN: I'm not including it

just because it's--

And this is from the paper by Pacala and Socolow.

The 15 wedges and how much land it

would take for biofuels.

And they look at--

and they don't have fusion.

I don't know.



Fusion, we can talk about.

It's in a glass.

Fleischmann and Pons.

I don't know.

If we can create the sun in a glass, where it's

not really that hot.

I don't know what that'll start.

Anyway, that's my physics background

thinking about that.

So green buildings, just for a moment, part of

the solution, clearly.

Many health benefits.

Many economic benefits, worker satisfaction.

You have lovely light here, and lovely buildings.

I'd like to learn more about what you do here.

Kids do better in schools, with tests.

People buy more in stores with sunlight.

That should move the Wall Street.

And patients do better when there's better

ventilation, and so on.

For developing countries, and this is the penultimate slide,

we can think about all of these distributed local

development issues that need energy.

And solar, and wind, and then you could hook a wire around

there, and get a bicycle, when the sun doesn't shine and the

wind doesn't blow, get folks to ride around on a bicycle,

or run around on horses.

There are ways of having distributed generation of

clean energy.

This can pump water, purify water, it can cook, it can

drive small development.

This is something that groups like ECO and COAL that I just

saw at the SRI.

There are groups that are pushing this because clearly

this is an issue for poverty, for clean environment, for

energy, this is a precursor.

So finally, I believe that we need to think about the policy

issues as well.

This is what Amy and I were talking about.

And businesses are beginning to think about this, Wall

Street's beginning to think about, what are the enabling

financial instruments, policy instruments, and framework.

So just to put out a potential way of thinking about a

framework, here's the carrots, here's the sticks, incentives.

We want to lead with those.

We need to align our rewards and regulation systems from

our own walking and biking, to what we do in our communities,

in our churches, synagogues, and where we work, and so on.

With what companies do, what the government does.

We need a new energy plan that deals with all of the issues

of transport, and housing, and utilities.

This can be the engine of growth for this 21st century.

This can be jobs put people to work, with the right

international framework, and funds, it can be a spark for

development with the removal of the perverse incentives and


So we're talking about rules here, and I want to

emphasize that word.

Lead with a carrot, to get the horse moving, this clean

energy transition, and transformation can be good for

public health.

It can be good for security, it can be good for the

economy, and we certainly hope it will stabilize the climate.

These are web sites, and I thank you very much.

MALE SPEAKER: Thank you Paul.

I think you've crystallized a lot of the thinking that we've

been doing here at Google and

Are there any other questions?

We've got about time for two.



MALE SPEAKER: May I ask you to say that again, so

NSA can hear you?

AUDIENCE: At the start of your talk, you mentioned that the

strengthening of the polar winds was one of the most

disturbing things to you.

Can you please briefly explain why that's so disturbing?

PAUL EPSTEIN: Well, that's a good question because

gradients is really what we're talking about.

Again back to the systems thinking, and if we're getting

cooler up there and warmer down around the tropics, we're

changing the winds.

Winds flow, and hot air rises and creates a low system, and

weather flows downhill, as it were, from high pressure

systems to low pressure systems. So as it cools around

the poles, because of this melting, we're getting changes

in the gradients, it's changing the winds, that's

changing the weather.

So temperature, pressure, wind, weather.

TPWW, basic physics.

and we're seeing wind storms go deep into Europe.

They had three in '99--

Lothar and so on.

That had one last January that knocked a year's worth of

forestry out of Sweden.

We're seeing deeper penetration of some of the

winds as these polar temperatures and pressure

gradients change.

Wind is concerning.

Wind is that element that cools you, warms you, it's

your friend, it's your enemy, and it drives

trade, and so on.

And so if we're changing winds that's disturbing.

And I do want to remind myself to say, systems like


They like equilibrium.

So I do believe that we can go towards a new equilibrium.

But, we've got to back off the pressure we're

putting on this system.

Some 60% to 70% in terms of greenhouse gases to stabilize

the concentrations.

AUDIENCE: That was the comment that I was going to make,

because in Al Gore's film, and in your lecture, there was

emphasis on the nonlinear aspect of climate change.

And I think people have this feeling that, yes, we will

start to do something, and then things will start

reversing fast, as they did with the ozone hole where we

see some signs of improvement.

Now that's after the Montreal Protocols.

But I think what I've been taught at school, like the

climate system is much more complex than that.

And, the warming of the ocean may actually be a barrier to

going back into the stable state, we had pre-CO2 level.

Pre-high-CO2 CO2 levels.

So I would encourage everybody who speaks on that to really

emphasize that point.

I mean, if we start doing something now that's not going

to change anything because these systems may settle into

an equilibrium state and then stay there for a long time.

PAUL EPSTEIN: Absolutely, agree with you.

We've had large ice caps, medium-sized ice caps, we're

headed towards small ice caps.

I did want to present this in a positive light then, that

there is a potential that we could stabilize at another

state that gives us a chilling-off period as it were

to go ahead quickly with this clean energy transition.

It's possible, we've headed towards that.

No one understands what the heck happened this year with

no hurricanes.

It may have to do with some of this ocean circulation,

melting and cooling off, and convection, and wearing some

of the heat.

AUDIENCE: My question builds on that general point.

Given that Nick Stearn's report has also confirmed the

fact that we need to act now, and not later in terms of

economic cost, how do you think we can incentivize

governments to put the incentives you alluded to in

place, given that sometimes political motivations conflict

with those goals?


That's a good, good, huge question.

And what is the framework for sustainable development, that

we all cherish?

There are three things that are in the way.

So we've really got--

before we think about all the incentives we've got to think

about all the incentives that are leading people to take

down their forests, to send for timber, or grow cows for

hamburger for McDonald's, et cetera.

So the debt is key.

The debt that we got into from the 70's, based on oil in

large part, is driving much of this fragility in terms of

states and failed nations.

There are perverse subsidies for oil and coal that are

clearly larger, and our wars, and so on are, I think about a

trillion dollars is what Tom Friedman of The Times

estimated was what we're spending on Iraq already.

So what we do for wars as well as oil lines, so there's a

whole perverse subsidy issue that's driving this.

And then the fundamental one is the terms of trade.

Something we don't talk about a lot, but what the Rwandans

are getting for their coffee is what they got in '62.

What they pay for a hamburger, or a tractor is

what you and I pay.

We've got to equalize the terms of trade.

So it's not just fair trade now, it's re-doing the rules

and the agreements of trade to make it fair.

So those are three obstacles.

And then we've got to provide large funds that are global

funds for adaptation and mitigation.

And here clean energy, I want to emphasize, is an adaptive

measure because it's distributive, it prevents,

protects when there are storms, and blackouts, and

heat-waves, and so on.

So it's part of adaptation that isn't usually talked

about, and mitigation.

And then we need to provide some institutional

framework for this.

So we need those three certainly.

We need the carrots, the fund's, we need new rules and

regulations, and rewards.

And we need some new institutions beyond the

Bretton Woods ones, which is the last time we

came together in '44.

[? Keene's ?] got the brilliant idea that we didn't

need to change, he figured out that we didn't need to figure

it all out.

We needed to just change the rules.

Change the financial signals.

And it was liberal trade in goods, but

fixed exchange in capital.

You can't just move it from Seoul to Thailand.

And I know we need to stop.

And finally the fixed exchange rates of $38 that was all

abandoned in '72.

So anyway, we've got to come back to new rules, new

incentives, and new kinds of institutional

framework to move this.

And I think you're a wonderful position to think about the

new technologies, and to think about this framework and

policies, and how businesses, and environmental justice

groups, and so on, can all get behind something that can

provide jobs and development as well as a healthy future.

MALE SPEAKER: Before we thank Paul, I want Amy and Kiersten

to stand up, just so you see them.

If you have any follow up questions on the environment,

please speak with them on climate change.

And I think Rachel is here, so maybe Katie if you'll raise

your hand, if anybody wants to follow up on issues of

economic development.

You should know that the most recent G8 round of debt

forgiveness provided less than 1/3 to the developing

countries whose debt was forgiven, then the negative

impact of the increase in oil prices.

So in other words, it cost them three times more for

extra oil than they got back for all the debt repayment

that we heard so much about.

So if we needed any other indication of how

interconnected all this is.

Paul, thank you very much for coming to Google.

I think we'd all like to thank you for coming.

We hope you come back again.

The Description of Climate Change and Health