The vice president of the more calm component, I think I know most of you have been in ACOM for over 40 years now. But in a previous life, this doesn't work. Not getting any movement of the slide, there we go. So that I have no conflicts that I'm aware of. It's my own ideas, not that of my employer. I'm going to have a lot of slides to go through, but I'm not going to read them. I'm going to have them up there for you to glance at, and it'll be in your packet. I used to be a meteorologist. I am not a poet, as you can tell. I flew hurricane reconnaissance off the coast of Africa, and it is a really area where a lot of heat gets generated and a lot of things happen. So the climate change in general is happening at a rate that exceeds anything prior recorded. I don't think we're going to argue that it's man-made in this group, but there are some who would. It's a worldwide phenomena, but it impacts areas differently. One area might find that they're getting more heat, and another area might find the winters are worse. But I want to specify weather versus climate. Weather is a day-to-day kind of thing. What is that like outside now? And climate is the long term. I like to think of it as what's in your closet. Weather is what you're going to wear today based on what's going on, and climate is what your clothing in the closet look like as you do it over a year. If you have lots of fur coats or parkas, you probably live in a cool climate, and if you have lots of sandals and shorts, you probably live in a warm climate, probably, but weather changes day-to-day. All right, so let's put climate change in context. It does vary over geologic times. It has occurred in the past four and a half billion year history, very dramatically changing from time to time. The geologic record tells us that. They have happened for a variety of reasons, and most agree that in the past couple of hundred years, we cannot explain it by natural causes. So it encompasses global warming when we talk about climate change, but it really refers to the broader change of things that are happening to our planet. So why is it a concern? Well, basically, it's going to create major economic, major health, and major psychological issues for both communities and individuals, and so people talk about two degrees. Because it's risen by that, if it raises another one and a half or so, we may be at what's called the tipping point where we can't go back, at least not in our measurable time. So we have to be aware of it. And again, like I say, it varies, and they go on different timescales. So if you look at—I'm going backwards, aren't I? All right. So this is the temperature over the last several hundred years. I don't think anybody would disagree that that's rising. It's rising significantly. There is argument over cause, but it is rising. And when it happens, we get more heat waves, increased heat-related illness. We get more severe storms. Look at the more recent years, hurricane numbers, increased droughts in some reason because in some areas it impacts things differently. We have rising sea levels. We see that already in many areas where what used to be land is now underwater. We can lose species, and we have increased conflict, food insecurity, poverty. It's not a good thing. So why do we want to look at Africa in particular? The changes there are pretty dramatic. The real problem there is that it may foretell what's going to happen in the rest of the planet given the way the systems work. Changes have had a significant impact, and they will continue to do that. But it's a population that's less able to deal with change. The change impacts us all, but many people can cope. We put air conditioning on. We change the location. Many people in Africa cannot do that. There's an increased need for aid in that area. And what impacts it? First of all, the location. It's in the southern equatorial region. There's a lot of land and sea contrast. It's hot in certain areas of the ocean, cold in others, and very hot in some areas of the continent. So we've got this difference that drives weather and drives both rain and drought. The ocean currents, I'll show you a diagram in a moment. The altitude, I mean, there are some areas in Africa that are quite high, but a lot of it is low land, and it's warmer as a result. And the rainfall, which comes about because of the way the ocean currents and the heat flow occur, and then it hits the mountains, and we get rain in some areas. We get drought in others. So there's Africa. I think we all know where it is on a map, well, although many people could not locate many places on map when asked. But you notice it's right in the middle of the equatorial region. And this is the heat flow, the temperature, the ocean temperature, that orange stuff, the yellow stuff, that's heat. And look where it's flowing. It's flowing both from the east and the west, right into central Africa. And in other places as well, in our Central America. But Africa is getting it pretty directly. And these are the currents in the ocean. I'm not sure it shows up as well as I would have liked, but you'll see that they bring hot air, hot water into the area off of the sub-Saharan Africa. And the impact on the temperatures, these are the temperatures in Africa, and you can see that the green areas are much warmer, and that's why the jungles are there, and that's why it's hot there. Altitude, here's a map of the altitude. The west coast has highlands for the most part. There are some in the central. As that heat and warm water comes in, it rises. As water rises, it cannot hold... As air rises, and my apologies, as air rises, it cannot hold as much moisture. So what's going to happen? We're going to get rain. Look where the heat, if you recall, is coming. Look where the warm currents are coming, and look how it's going to hit the mountains and basically drop the water. Here's the rainfall. That green is that big area in central Africa, and at the same time, of course, the Sahara doesn't get any because of the way the currents and the moisture flows. Now, these are the climate zones. It's just... You can see that the central is heat and equatorial. So again, why look at Africa? It has warmed in Africa more than the global average since the pre-industrial times as we're looking at it. In parallel to that, and maybe as part of the cause of it, rises along the African coastline is faster than the global mean, and it contributes to the increase in the frequency, severity of flooding, erosion of the soil, salt water overriding what otherwise would have been a fertile field. That's why Africa may be a bellwether of what's in store for much of us if we don't do something about the rising temperature. Here's the temperature rises in Africa. The change is sort of an inflection point about 100 years ago. Of course, that problem at the core is the temperature increases the heat and all the things that come along with it. It causes loss of lives directly. It causes property damage, population displacement, and it basically undermines Africa's ability to achieve the things it would like to achieve as part of the larger goals of the UN Sustainable Development. Now, I don't think you could ... Did I go back again? Probably. All right, food insecurity, the climate change is increasing it. It destroys and disrupts food crop growth. It destroys food transport from one place to another. A lot of the world's drought occur in Africa and even into sub-Saharan Africa. They're enduring a drought of decades proportions. A lot of food and other areas are getting torrential rains and they can't grow crops. There's a lot of problem there because of that temperature. This is just a picture of hunger metrics. I want to point out that if you look at the darkest blue, it almost exactly parallels the heat. Now, you would think that heat and rain are great for crops, but they're not. Crops of certain kinds have developed in areas. They grow well in certain climate. Again, climate is the long-term change. If you get a change in that climate picture, you're going to have trouble growing those crops. Switching from one crop to another is not always as easy as it might sound. There's water, water everywhere in Africa. We saw that, all that rain, but not a drop to drink. A lot of that water is salt water. A lot of it is torrentially coming down and running off, destroying the soil and making it difficult to be used for drinking water. Sea level rises, I'm not going to go into it greatly, but it threatens a number of the cities along the coast. Areas where great economic development has occurred and where the future of Africa's economic and therefore other aspects lie are being invaded by the sea. They no longer can do what they did. Ports are hard to use, the overriding of even the facilities. Land is lost, and that's happening greatly in Africa. The aquifers are being contaminated. Salt water is getting into them. You can't drink that unless you process it. Hundred-year floods were supposed to happen only once in 100 years. Many areas in Africa particularly are projected to be one in 40 years, and one in 20 years at four degrees global warming, which is not out of the question if we don't change. The coastal cities have been growing, but the rising sea is knocking them down. Warming temperatures, it causes more rain, it causes more problem with salt in the soil. It adds to food insecurity, even though it's raining. Conflict occurs when people are short of resources. I'm not going to read it to you. You can read it yourself. But increasing food insecurity, increasing land availability, economic factors are all driving a lot of the areas of Africa into conflict. Beyond the direct warming, we get shifts in fish, where the fish are. So a population that depends on fishing for its food is finding that those fish have moved to a water climate that is more conducive to their growth. Land that gets lost, we keep going backwards. All right, now this is reverse. I apologize. So in summary, global warming is everywhere. We know that. It's a globe. It's not going to not happen in certain areas eventually. But Africa has had it to a larger degree, because where it's located, it's geography and factors that impact ocean currents that impact Africa. And this results in increased both direct and indirect issues of heat-related illness, of course, severe storms, drought, food insecurity, loss of species, poverty, displacement. Just name it. It happens. And like I said, it's a scary picture that it may be a picture of what is to come to the rest of the planet unless global warming is controlled. Thank you. We'll take questions later on in the session. Thank you, Dr. Auerbach, for introducing the topic and an occupational environmental medicine physician as well. So really nice to tie the two topics together. Welcome again to those that have joined us. My name is Kushinga Bute. I am the resident representative for the environmental health section here at AECOM and also the corporate medicine section. And I am part of the JEDI committee. I really am drawn to this topic because for those at the international section yesterday, I kind of gave you a little bit of an insight of my background. I actually attended medical school in Zimbabwe. And coming from what was formerly known as the breadbasket of Africa, occupational and environmental medicine was part of our curriculum. So during our preclinical years, we had to go and visit farming communities and practice medicine there and incorporate a good occupational history. And we also spent a lot of time as well visiting mines. And I remember in my third year, I went to one of the largest coalery. So anything that's related to population health is something that I've actually experienced on the ground because even after medical school, I actually spent 10 years in Zimbabwe working in the public health sector. So I'm going to spend the next 10 minutes. I've got about seven slides just trying to reemphasize the importance of trying to understand the impact of climate change in Africa. And my main purpose is just to increase awareness of the severity of the matter. So there's 17 United Nations Sustainable Development Goals. And what these goals basically do for those who are unfamiliar with them, it's basically a call to action for all of us, especially those who are in the public health sector. Whether you're from a developing nation or a developing nation to actually come together and form some form of a partnership to address some of the global health challenges. Now there's a direct correlation between climate change and the Sustainable Goal Number Two, which urges all of us to put in some form of efforts to end hunger, achieve food security, improve nutrition, and to promote sustainable agriculture. Now by a quick show of hands, if the rainfall in 2023 was maybe, let's say, 30% lower than it was last year, how many of you here would lose their jobs? Okay, no hands. By the end of the year, let's say, again, the rainfall didn't quite pan out to be what we expected, how many of you would be unable to send their children to school? So everybody really here in this room doesn't have a direct correlation between climate change and your quality of life, just by the few questions I've asked. But that's not really the case in Africa because about 60% of people earn their income purely from agriculture. So when climate change hits, that's basically your lifeline. You lose your ability to send your children to school. You lose the ability to have income to go and see a doctor. So there's many layers about the impact of climate change when you're living in that part of the world. Now farming, mind you, is actually a very good business because it can be guaranteed of business, right? Everybody, every human being for now requires some form of food. But if you're not in control of the rain, if you're not in control of the weather, there's just so much risk to it. I myself am a beneficiary of the income that's generated from agriculture. A lot of my graduate training came from income from back home because of farming activities. But like I said, when climate change changes the ability for you to get a decent yield, a lot of people not only face food insecurity, but it's really about changing in the quality of life. Now according to the WHO, there's about 14 million people who really need some form of food assistance. And if you look at sub-Saharan Africa, there's about a 45% increase from 2012 in undernourished people. And, you know, because of climate change, the availability of arable land continues to diminish. And the last numbers that were published show that the arable land has decreased by 20%. So the impact on Africa is a lot different than climate change in the rest of the world. Now when we talk about climate change, we're not talking only about, you know, food security and weather. I think I've gone back. There we go. But there's a correlation as well with access to water because 70% of the water that we consume as human beings is actually used in agriculture. But there's such a scarcity of water that I think sometimes when you're living in this part of the world, you actually take for granted. Dr. Alba mentioned briefly that, you know, we faced a lot of drought. I remember when I was in my teenage years in the 1990s, Zimbabwe experienced a huge drought. And I remember a lot of my relatives had to migrate from the rural areas and they came to the cities because a lot of them didn't have any skills or any additional form of training. So there was no alternative option. And I remember my father, who was an entrepreneur, ended up employing a lot of our family members to work at his gas station. So again, what we're trying to also emphasize is that because of the climate change, there's a huge migration of people from the rural areas. But that also comes with its own set of challenges because, for example, in my country where I come from, the infrastructure did not change at a fast pace to accommodate the migration of people who left the rural areas and came into the cities. So the system is overwhelmed in terms of managing human waste. And there really isn't availability of fresh water. So the way you value water is very different from somebody who actually has to make an effort to walk miles to just get a bucket full of clean water. And the struggle is really to see how governments with their limited resources can actually prioritize. If you're managing an economy where every single year you're dealing with outbreaks related to unclean water, every year there's some form of diarrhea outbreaks, there's always a few hundred people who lose their lives from cholera. At the same time, like I mentioned, you're trying to address the need to redo the infrastructure to manage water supply and waste. And at the same time, you're also coming to the terms that climate change is affecting your ability to generate food. How do you prioritize these things? And the information is available even to the leaders in Africa. They're aware about the improved means of agriculture, such as drip irrigation. They're aware of the option of desalination. But the reality is that there's just so many competing forces for the limited resources that are available. So when we look at the sustainable development goal number six that urges us to ensure the availability of at least giving people clean water, right, I mean, you don't even think about it. Opening a tap. I know a lot of you prefer bottled water, but just that luxury of actually opening a tap and having running water is a luxury. I'll tell you about what life is like in Zimbabwe if you're living in an average household. Because most people no longer have running water, a lot of people have to buy water, and what they end up using is the bathtub as a reservoir. So whenever you need to use the restroom, you know there's a little container on the side, you have to scoop water out of the bathtub, put it into the toilet, and that's how you flush. But if you need to take a bath, you have to bring a small pot of water again, scoop a bit of water from the bathtub, and if you're lucky to have electricity, you then put that pot on the stove and then you use a little bucket to actually clean yourself. And sadly to say there's an entire generation who have not even experienced what it's like to see water coming out of a tap. So there's so many dynamics when it comes to the impact of climate change and so many moving forces that it really becomes a challenge for the leaders in that part of the world to come up with a solution. And according to the numbers that are issued by the WHO, they actually estimate that it will take approximately $650 billion each year just to finance changes to produce some form of water sustainability in this part of the world. And we look at the numbers for each year, they're saying that if you just want to have some form of clean water supply and sanitation in Africa, it will probably cost you about $200 billion each year. And if you want to have some form of a sustainable irrigation system, you'll probably need about $100 billion each year. And when they try and estimate how much it would take to achieve this, unfortunately, and this is reported by the Netherlands-based Global Center on Adaptation. And in addition, specifically to malaria, the deaths have decreased significantly, from 840,000 deaths in 2000 to, after 20 years, 600,000 deaths, so over 200,000 deaths less. But the disease is still a major health issue. Climate change has caused severe consequences on the lives and livelihoods of millions of people around the world. But due to accidents of geography, different populations face distinct sources of vulnerability based on their exposures to cyclones, storm surges, droughts, intense rains, wildfires, and other physical phenomena. I have a graph in a few slides to show this and how it's distributed. But this can affect the people of Africa's health status, level of education, access to services as well. Given the high exposure to climate change and relatively low community resilience and government capacities, Africa may be the most vulnerable continent to climate change. So this is kind of going over the different vulnerabilities in Africa and how they're distributed across the continent. These include cyclones, chlorobleaching, desertification. As you can see, there's a wide variety of different vulnerabilities scattered all across. This is an example of high vulnerability areas with respect to climate change. As you can see, there is almost a straight line, a horizontal line, across the middle of Africa from the west to the east. With the east kind of having higher vulnerability, a little slightly higher than the west. But as you can see, the darker shaded areas are the highest vulnerable areas. The most vulnerable areas. So this is a slide going over malaria in Africa. There are over 435,000 deaths per year. And it disproportionately affects children under five, unfortunately. Recent advances have reduced case burdens, as I showed. There are significantly fewer deaths in general compared to 2000, the year 2000, though bed net distribution, household level spraying, and rapid clinical diagnostic and treatment responses have appeared to slow down the rates of infection. The World Health Organization has stated that for 10 high burden African countries, there's an increase of 3.5 million cases in 2017 over the prior year. In addition, many countries with a high burden of malaria now have weak surveillance systems and are not well positioned to assess disease distribution and trends, making it difficult to optimize responses and respond to outbreaks of malaria. This is a slide going over the deaths from climate change in Africa, specifically climate change. And there are 150,000 per year that are attributed specifically to climate change. And as you can see, Africa generally suffers from this, but you can see that in the southern parts of Africa, they are disproportionately more affected. So the term global warming is misleading. There is an intergovernmental panel on climate change. And there, they report that there is a scientific consensus on climate change. There's a peer review process with very high levels of scrutiny and credibility. And this represents a multitude of expert opinions that climate change is indeed an existential threat to our way of life. There are many other environmental impacts of climate change, including more extreme temperatures, sea level rises, hurricanes and storm surges. And what we will go over in the coming slides are the increased range for disease vectors. As you can see here, human health is affected disproportionately in Africa by these infectious diseases and water and food-borne diseases, which is why we're giving this presentation. The more vulnerable populations, unfortunately, the elderly, young children, people living alone, socially isolated, mentally ill, people who work outside, taking certain medications. In addition, there is increase in heat-related illnesses and mortality, including heat stress conditions like heat cramps, exhaustion, and heat stroke. Here you can see some pictures of examples of increased precipitation and flooding and the effects on the livelihoods of various individuals across Africa. And also, as increased zoonotic and vector-borne diseases, as you can see here, you can see that for some examples of these diseases that can be transmitted are Lyme disease, West Nile virus, dengue fever, malaria, chikungunya, and rabies and tularemia. And I'll have some more detailed slides in a bit. Africa also suffers from water and food-borne diseases. This is due to increased air and water temperatures, which increase replication of these disease vectors. And heavy rainfall and flooding facilitates rapid transportation of these pathogens, unfortunately, to water supplies. This is a slide about malaria hotspots. So they particularly occur in central Angola, northwestern Zambia, northern Tanzania, and the southern coast of northern part of Mozambique. And so malaria hotspots also include Malawi, Tanzania, South Africa, Botswana. There's also a novel endemic and seasonal risk. I guess as the seasons change, the disease risks change as well. So some novel areas with no history of malaria transmission become suitable for endemic and seasonal transmission as time goes on, unfortunately. A key concern with climate change impacts is whether climate change will lengthen the period of the year during which diseases can establish and be transmitted. In some cases, malaria may shift from being a seasonal disease burden to a year-round burden, unfortunately. This is a graph showing that there are seasonal and then endemic malaria transmissions in sub-Saharan Africa. And there is overlap between these two areas. So unfortunately, some people get a dose of both. So there is ADDs-borne diseases. There are ADDs-borne diseases in Africa as well. The ADDs mosquito transmits and infects various important arboviral pathogens, such as yellow fever, dengue fever, chikungunya, and Zika. These viruses share ecological niches and are transmitted by, as I said, ADDs mosquitoes and maintained in the environments in enzoonotic cycles involving non-human primates and sylvatic ADDs mosquitoes due to the genetic similarity between humans and primates. The diseases they cause collectively are called ADDs-borne diseases, ABDs, and now are listed among the most important emerging arboviral diseases impacting public health in Africa through devastating outbreaks that are currently evolving in frequency, geographic scale, and magnitude. This is a slide about yellow fever. So it's a flavivirus. So there are currently interventions involving implementing mass vaccination and vector control in West Africa and Americas, and those occurred in 1940 and 1960s, that put it under control. However, it reemerged in West Africa and spread to Eastern Africa, including Ethiopia, Sudan, Angola, and Democratic Republic of Congo, resulting in 100,000 cases with 30,000 deaths in Ethiopia alone. Meanwhile, outbreaks intensified in Nigeria in the 1980s, resulting in 120,000 cases with 20% mortality. The most recent outbreaks occurred in East and Central Africa, affecting urban areas in Luanda province of Angola in 2015, resulting in 7,000 cases and 500 deaths. In addition, it spread to Kinshasa, which is in the Democratic Republic of Congo, by July 2016. This slide about dengue fever, oh, sorry, dengue. It's a flavivirus as well. There are various serotypes. So it is endemic to more than 100 countries worldwide, with 40% of the world's population being at increased risk of infection. However, in Africa, its endemicity is poorly defined, despite documented evidence of circulation of the virus since the 18th century. Dengue outbreaks are driven largely by fast-growing populations, rapid urbanization without adequate sanitary provisions, deforestation, and increased travel and climate change. Some of the symptoms of dengue can be related to dengue fever, headache, retro-orbital eye pain, myalgia, and arthralgia, with 5% to 10% of cases being even more severe with severe hemorrhagic fever and or dengue shock syndrome, characterized by thrombocytopenia, plasma leakage due to increased vascular permeability, and severe organ failure, usually associated with secondary dengue infection. It is widely believed that dengue fever only occurs in Africa. However, recent evidence has documented severe disease during outbreaks, such as those in Nigeria, Burkina Faso, Tanzania, Egypt, and Kenya. This is a slide about chikungunya. It causes chikungunya fever. It is an aflavirus belonging to the Semeliki forest antigenic group. Human infection presentation ranges from asymptomatic to acute onset of fever with rash and arthralgia. Chikungunya fever exists in three evolutionary clades, West Africa, East Central, Southern Africa, and Asian lineages. There was the first outbreak in Tanzania in 1952, and it was thought to be gone for 45 years. But ultimately, it recurred in the Democratic Republic of Congo in the 2000 era and affected over 50,000 people in Kinshasa. Subsequently, outbreaks have continued to occur in Western Central Africa, including Cameroon, Gabon, Central Africa Republic, and Senegal, and Eastern Central Africa, affecting thousands in both rural and urban settings. Zika virus is a flavavirus. This slide is about Zika. It was discovered in 1947 following isolation of a febrile monkey, and then they detected AEDs, Africanus mosquitoes, all sampled from the Zika forest, which is, you know, for whom it's named, or for what it's named, with subsequent detection of human cases in Uganda in 1960s. Detection of Zika with humans has been documented initially in 1954, actually, when three cases presented with fever and jauntus were identified in Nigeria. Zika virus exists in two lineages, in African and Asian, with African lineages further evolved into two sub-lineages, East and West African, all having emerged from East Africa. Then we have the malaria and AEDs-borne diseases, ABDs. Climate change threatens to alter the nature of future malaria exposure across sub-Saharan Africa, and during the last couple of decades, re-emergence of ABDs globally have occurred, but particularly in Africa, where outbreaks have become more frequent, widespread, and possibly severe. Recent re-emergence of yellow fever, dengue, and chikungunya viruses in West and Eastern Africa and the threat of Zika virus have led to increased reports of urban YF, oh, yellow fever, outbreaks affecting large populations, including urban areas, and is of great concern, and trends should be checked in this regard. The weaknesses of public health systems in the affected countries that I mentioned impact disease detection, diagnosis, case management, and reporting, and could allow these diseases to spread even further if unchecked. There's a great need of surveillance and ecological studies that can inform the geographic risk and burden prevention and control. We can play an important role in combating climate change. We can encourage green practices, energy efficiency in our medical facilities, we can provide brochures to patients, relevant literature and informational posters in waiting areas and lobbies to educate patients and their families about how they can reduce their emissions. We can make recommendations to patients that improve health and well-being and reduce greenhouse gas emissions, such as eat less meat, walk and bike more, and use public transportation. There are various also vector-borne disease adaptation strategies, including working with local governments, setting up early warning systems to monitor insects, pests, invasive species and disease vectors, as well as anticipatory guidance for patients and their families, including staying indoors during dawn and dusk, removing standing water outside where mosquitoes can breed, wearing long pants when hiking in areas with fleas and ticks. And there's a last one there, but it's hard to read because it's in yellow. So thank you. Next up is Dr. Silverman. So I'm Warren Silverman, and I apologize for my voice. My vocal cords were cut in the past, but I got involved in environmental health a couple of years ago. I became the chair of the environmental health section and not knowing a great deal about it. I've taught myself a lot about it, and I'm pretty convinced that particularly for our younger doctors, it's going to become increasingly important. As we separate workers from hazards, the O part of what we do is going to probably diminish. But as we move forward in our environment, the E part is going to go up. And so we're trying to figure out ways for our younger doctors to become consultants and do different things where they can actually make a living doing occupational environmental medicine. If any of you know me, you know that I spend a lot of time future thinking. I'm always thinking about 50, 100 years from now. And a lot of what I'm going to talk to you now about relates to that future thinking. So with regard to Africa, why do we care? And I think besides the issues we've talked about that are current issues, the trajectory is important that we understand what's going to happen. To be honest, as I travel around the world, I think that it's pretty clear that in the next half of this century, from 2050 to 2100, Africa is going to be the major area of global powerhouse growth, economically, population-wise, various ways. So we really have to pay attention to what happens there, because if we do it wrong, there will be a lot of geopolitical unrest, and the whole world will be affected, not to mention the population of Africa, which would suffer. So when we talk about temperature, you know, we talk about 1.5 degrees Centigrade. By 2050, in Africa, it's going to be a bit higher. It's estimated 2.6 to 3 degrees, and in some areas, in excess of 3.5 degrees. And you can see from the map there what that means. But in a real sense, in Africa, they don't really have that much of a corn crop, even wheat, because it's too hot. And the major grains are actually millet and sour gum. If you look, though, this is in the past already, 2000 to 2009. These red areas are areas where they can't even grow it anymore, where it used to be growing. And you can see the top two are different strains of millet, the bottom two are two strains of sour gum. And it ranges up to 100 percent loss of crop. There are estimates that in the near future, up to 20 percent of the arable land is going to be lost. That's pretty important in an area where the population is going to rise dramatically. There's also economic losses, too. This again is already past. So these are not projections, this already has happened, 2000 to 2009. And we can see there's economic impact, there's crop impact. It's really sort of a difficult situation. Now on top of that, we have the people factor. It's estimated that between 2020 and 2050, the population is going to double. That's pretty impressive. But what's even more impressive is that 20 years after that, it will triple. In Africa, there are going to be 74 urban areas with greater than a million people. If we want to compare that to other places, if we combine all of the urban areas in the United States and Europe, that's more areas in Africa. On the other hand, there are many urban areas that have less than 500,000 people. Now I often tell people there are a variety of reasons why in the future young people will leave rural areas and move to urban areas. The most obvious is if agriculture is diminished and they make their living with agriculture, that makes sense. But even globally, young people with their cell phones and the way that they interact don't want to live in a rural area anymore. We see that. We've already seen that happen in places like China and other areas where there have been mass migrations of young people to urban areas for socioeconomic reasons. Africa will be the same. We'll see mass migration of people from rural areas where they're not able to farm the land anymore to urban areas. Now if we look at the impact economically, Ethiopia does grow wheat and they make a third of their GDP from wheat. And most of the people in Ethiopia, the majority, depend on agriculture. But it's projected that about 43% likelihood that this will really be disrupted. It won't really be an option. It also provides a lot of the caloric intake. Just the same with coffee. It's a big source of income in these countries. And we anticipate that a lot of these economic engines will be disrupted. So here's where we get to the interesting part, the future part. How are we going to feed all these people? Well, the way I see it, if you go up to a little kid in 2100, assuming we're still going to be here, and you say to them, you know, back in 2023, we had chicken and we had beef and we had salads and we had all that stuff. They'll say, ew, how could you possibly have eaten that stuff? It sounds terrible because they're not going to be eating that at all. There's a lot of research going on now about man-made protein, protein made from chemical stock as a food source. One of the interesting things is artificial intelligence and in fact some of the high-speed computers being generated are actively working to devise potential protein structures that can be utilized for food. Now you say, what does that mean? Well, if I give a computer the molecular structure of a taste receptor for sweet and I tell the computer, find me some proteins that'll stimulate that receptor with some of the exascale computer capacity, which are trillion times more than what we have now. They'll be able to just in a few minutes come up with many, many different structures that will taste really good, be very sweet or very sour or very something or will smell good. Because it will interact with our body in a way that makes us feel good. Now, this is an interesting concept, making protein out of air. Well, what do we have in air? We have carbon dioxide, we've got nitrogen, we've got all kinds of building blocks for making protein. It's projected at some point in the future that we'll be able to make protein out of air. And if you look at the figures down there, compared to making meat from a cow or something like that, if you make it out of air it's projected it'll take four days to make the protein, whereas the animal will take three months. It says here that basically it uses a fraction of the amount of water that we would use. And the land mass necessary to produce that much protein, you would compare the size of Texas for using animal protein versus the size of Walt Disney World. I don't know why they picked that place in particular. But that's what they picked. And 0.8 liters of water versus 15,000 liters per kilogram of beef. This is future thought. This is what we're going to eat. And there are going to be different alternative sources. Insects are already being used in places pretty much other than the United States and the developed world. When I go to Cambodia, which I do often, I went to some rural places and they said, oh, you're a special guest, let's bring out our special food for you. And they brought out a big bowl of beetles. My tuk-tuk driver, he said, I want you to try a delicacy. And he brought me down there to eat snakes on a stick. And as you can see, insects are being utilized around the world for a large number of things. I, you know, in Phnom Penh, you can sit down and have a tarantula salad. Very tasty, crunchy, crunchy. This was, I brought actually, I got to admit, I smuggled some of these into the United States. It comes in a big plastic bag of dried baby frogs. And they eat them like potato chips. They're very crunchy too. But it's a delicacy, dried frogs. OK. So, people are eating different things around the world. They've got lots of fish and they've got lots of vegetables. But this is what they're getting used to eating. Now, everybody talks about protein, but our diet is not made up of just protein. Carbohydrates, this is interesting because the estimates are that on the earth's surface, we get between 1 and 20 megajoules of energy per cubic meter. But we know that the caloric intake of a human is in that range, 7 to 10 megajoules per cubic meter or per day. So theoretically, a space that you stand on would be enough energy to feed you. The interesting thing is in the future, we'll also be making carbohydrates in the lab and we'll be eating them. This is interesting. Imagine looking up and seeing a platform in outer space that's 10 miles wide and 10 miles long. And the only thing on it are robotics and an AI device to run it. And they have 24-hour sunlight because it's in geosynchronous orbit. And the water is recycled. They have to replace it, very little of it. And when it's ready to be harvested, the robots will just scan across that gigantic field, push it all into a vehicle, let it drop down to earth, use very little energy. And these vehicles will land with tremendous tons and tons of vegetation. That's interesting. Requires no people, but it's a way that we can solve some of these problems. And this is really interesting now because, you know, I was just down in Barbados and a lot of the Caribbean is suffering from the fact that there are large masses of seaweed that are washing up on their beaches and ruining the tourist industry. I don't know how to pronounce it, Saragossa, whatever, the seaweed. That is really problematic. But the reason is because the ocean temperature going up is very conducive to growing seaweed. Now, the other idea that they have is what if you had a field of seaweed that you were cultivating hundreds of miles long, hundreds of miles wide in the middle of the Atlantic, and you had vessels going out there every day just skimming all that off the surface, they estimate that a sea vegetable farm of 180,000 square kilometers about the size of Washington State could produce enough protein for the entire world. That's an interesting solution. It's happening already. People are developing those resources and are working on those farms out at sea. But you don't hear about it, but it's happening if you look in the literature. Everybody is interested in fungi. Fungi are easy to grow, and they grow everywhere, and you can produce large masses of it. What we haven't developed yet is the technology to turn it into palatable food in many forms, and that's what's going to happen over the next 50 years. But it really is an option that we have to follow. We have to try to make different things. I'll show you here, the next one anyway. But we're going to be able to make meat, and we're going to make all kinds of things that are out of fungal elements. This I don't expect you to read, but it's the history of fungal nutrition in the human population. Okay, I'll do just a couple more really quick. So as you can see, we have an increasing love affair with fungus, and we'll be able to produce large amounts of fungus and process it and make food products. And that's happening again. There's a conference in San Francisco called Future Food, and there are vendors out there producing these things. Algae, again, we're producing these things and moving them forward. Producing products like these, we're going to have fungal, I mean, algae pizzas and algae everything. These are all products that exist. And they're going to be part of our diet. All right, so I'm out of time anyway, but here's the general rule. Food that is raised or harvested is going to disappear by the end of this century. Very little of it will exist. Food will be manufactured, and we need engineers right now, food engineers that can make it palatable, make it interesting, make it taste good, and make it and market it so that that kid in 2100 is going to say, I love this, whatever you want to call it, but I can't imagine that you ate a cow. How could you have eaten a cow? So that's the future. And Africa, if we don't get it right in Africa, if we don't feed these people, if we don't have everything in Africa, the geopolitical consequences for the entire world are going to be a big problem. Thank you. Thank you.

climate change

Africa

agriculture

economic stability

population growth

crop losses

arable land

mass migration

alternative protein sources