and so this is my fourth book and i came to seattle for my first book on book tour and i think three people came to my event one was my friend one was my cousin and one was a guy who came in to take a nap so thank you all so much for coming when i first started writing this book about six years ago i did not expect that we would actually be living through a pandemic of a brand new pathogen when it came out but of course virus spreading explosively across the americas and across the cross the globe in fact and this is really a good example of why i wrote the book over the past fifty years we've had over three hundred infectious diseases either newly emerge or reemerge into new places where they've never been seen before so it had ebola and west africa never saw it there before we've had novel kinds of coronaviruses that cause diseases like sars and a new one called middle east respiratory syndrome we've had new kinds of avian influenza coming out of asia including one that caused the biggest outbreak of animal disease in u s history last year we've had a lot of new insect borne diseases from tick borne illnesses like lyme disease and others west nile virus chicken cetera so this sense that a pandemic that is an outbreak of diseases starts in one part of the world and then spreads like a wave across global populations is certainly growing and that's not just me being worried it's also the opinion of experts so this is a two thousand  study that was done among emerging diseases experts who said the majority said that they believed that a pandemic that would sicken a billion people kill one hundred sixty five million people and cost the global economy three trillion dollars would occur sometime in the next two generations so the question is which one and we have a lot of contenders right we have one hundred fifty thousand species of bacteria nearly a million viruses that can infect mammals so figuring out which one of all of these is going to cause the next pandemic is possibly something that won't be possible to do but while we can't know which one we can know how this happens because in in modern history there's only been a few pathogens that have been able to cause pandemics we've had your senior pestis which cause the plague pandemics influenza which causes seasonal flu pandemics very yellow which causes smallpox hiv which causes the ongoing aids pandemic and then the fifth one is cholera which causes the disease we know as cholera and this is the one that interest me the most in part because it's really deadly it can kill you in a matter of hours it kills about half the people who get it if they're not rapidly treated but more than that it's one of the most successful of all of our pandemic causing pathogens because cholera has caused not just one or two global pandemic it's caused seven global pandemics and the last one the latest one is still going on right now just a few hundred miles off the coast of florida and haiti so we think of cholera as a poor person's disease and that is true today but that wasn't true when color first emerged when it first came out in one thousand nine hundred it hit the most advanced cities in the world cities like new york which was repeatedly plagued by cholera outbreaks in eighteen hundreds and not just new york but also london and paris and new orleans and all these the really most advanced cities of their time and these weren't just very deadly thousands of people died they're also highly disruptive and this is something that's common when there's outbreaks of novel pathogens as people don't know where they come from they don't know why it suddenly arrived doesn't know what they don't know how it spread and they start to in this face of all this uncertainty and panic they start to blame each other so in the eighteenth thirt people blamed the collar on the irish in one thousand forty's it was blamed on the muslims by the eight hundred ninety s collar is being blamed on the eastern europeans and this wasn't just sort of social exclusion this was actually violent scapegoating this picture is from an excavation that was done in two thousand and nine right outside of philadelphia as a structure a railway track and what happened there is irish immigrants had come over an eight hundred thirty two to work railway and there had been a cholera outbreak so the local community sort of corn team the valley where they were staying then secretly they came back and they massacred all of them and they buried them in this mass grave which is where recently archaeologists found their smashed scolds and and bullet ridden skeletons but it wasn't just marginalized communities that were attacked scapegoated it was also health care workers so physicians during cholera outbreaks were routinely stoned in the street mobs would form a cholera hospitals and they were often burned down there was a frequent kind of social phenomenon called cholera riots and this is like a common thing that happened when there was outbreaks of cholera so the question i want to ask is how does a little micro cause all of this craziness and death and destruction i mean you think about a microbe it doesn't even have any independent locomotion so what i wanted to look at is how how does a little microbe turn into this pandemic causing pathogen and what i found is you know there's really a multi step process and a lot of it some of it has to do with science but a lot of it has to do with how we live so cholera actually originates in the environment and this is true of a lot of our new microbes today color is a marine bacteria that normally lit naturally lives in aries coastal waters around the alkaline and the bacteria just naturally lives in this environment in the water actually lives in conjunction with zooplankton and in that environment it performs a useful ecological function it helps to recycle nutrients and for a long time you know people didn't get into come into contact with the bacteria very often of course that all changed in the one nine hundred century when the british raj decided to settle the surrender bonds and turn them into rice fields so over the course of that century ninety percent of the sunderbans was settled in quite suddenly you know humans had invaded cholera habitat and we came into novel contact with that bacteria and as we did that the bacteria came into our bodies and started to adapt to us and of course inside our bodies cholera bacteria is not particularly useful useful part of our habitat if you ingest a little bit of cholera bacteria it lines the interior  and it actually reverses the normal functioning of that organ so that instead of nourishing the body with fluids the cholera infected got actually extracts fluids from the body and expels them in a massive torrent of water diarrhea and vomiting actually a person infected with cholera can lose of to fifteen leaders of fluid a day and that's what kills you you just die of dehydration essentially in a matter of hours so it kind of desiccate you alive and of course each drop of that waste that is teeming with the bacteria so anyone who comes into contact with it on their hands and their food or in their water the bacterial spread to them too cholera started in the city runs in eighteen seventeen and it spread up into russia went out into the industrializing cities of europe but of course to cause a pandemic it would have to cross the oceans and all of this was perfectly timed with the arrival of the steam engine so this was the era you know the new new industrial era and we transitioned from sail ships to steamships and this allowed people to start travelling across ocean a lot faster instead of eight weeks it would just take a week to cross the ocean in addition we had all these nice waterways here in the united states but we weren't able to go we only could go downstream until we had steamships then we could go up and down better than that we used  build canals so the erie canal for example opened in eighteen twenty five connected all the waterway traffic of the atlantic with the interior mississippi valley all those waterways so we had created this kind of seamless watery network and it was perfect for cholera to come over from london to paris into canada and then filter out throughout the interior of north america and of course all of this meant that a lot of people were moving to to people who were abandoning farms coming to the cities for the new factory jobs you know places like new york there would be about seventy seven thousand people crammed into every square kilometer there because there wasn't a room to sprawl of course everyone had to live near work or near the possibility of work so people were coming into much closer contact their breathing on each other more they're touching each other more and of course all of this would create a huge sanitary crisis people simply kind of transplanted their ways they managed human waste in the countryside into the cities the city life was a new thing and sue people used just pools and outhouses and privies and there was no sewer system to carry the stuff away or treat it there wasn't even every there wasn't even any laws that said you had to empty out this stuff so all this material was allowed to kind of sit and build up and spill out into the streets and into people's wells and down into the ground water a typical nineteenth century new yorker was actually ingesting about two teaspoons of fecal matter every day so as soon as cholera entered into this environment it was just able to explode and that happened again and again over the course of the eighteen hundreds of course there's things we could do we don't take these things lying down but at the same time as all of this was happening we had you know this is the air of the robber ba rights to private interests have become incredibly powerful and sometimes they were directly in conflict with the public health strategies that might have contained cholera so for example in eighteen thirty two doctors collected this data showing a pretty clear picture cholera is coming down the hudson river in the area canal and it's heading straight for new york city so the obvious thing to do to protect the city would have been to quarantine the waterways but private interests thought they would be far too disruptive and so they never did it and cholera came down those water is infected new york again and again in fact there is companies who are making money distributing cholera contaminated water to the people of new york the epicenter a lot of the epidemics occurred in the slum called five points if anyone has seen that martin scorsese movie gangs of new york that's about five points so this is where a lot of the epicenter of the epidemics was and this slum had actually been built on what was once a pond that was the only source of fresh water and in manhattan when i was first settled it was called the collector pond it was filled up with garbage and then the slum was built on top of that pond so the ground underneath was unstable it was you know low lying and of course the groundwater underneath that was very easily contaminated with all of these cesspools and privies of the slum on top of it but the company that the state of new york chartered to deliver water to the people of new york they didn't want to spend a lot of money they didn't want to spend the money that would be required to tap upstream sources of water which would have been cleaner and fresh and when it tasted better they wanted to save money so they did sort of like what happened in flint michigan sadly they sank their well right in the middle of that slum and they delivered that water to one third of the people of new york and this was through multiple cholera outbreaks and the reason they did that actually is because they wanted to start a bank they want to save all the money start a bank and the bank actually became you know it worked in the sense that it became a very successful bank does anyone know what the bank of the manhattan company is known as today yes j p morgan chase biggest bank in america so there's things doctors could have done at the time to the cure for color is not technically very difficult it's basically clean water you just have to rehydrate people but people are not doctors at the time were beholden to theory about how diseases spread called m and this was the idea that diseases like cholera essentially soon spread through bad smells they were called miasma as they were smelly errors that kind of rose up from wetlands or you know decomposing organic material and so this their economy and sense for old diseases like say malaria which was common at that time to malaria isn't carried in smelly areas but it's certainly mosquitoes that carry malaria do rise up from wetlands and sort of sulfurous ones and things like that so me as much as i to work for some of the old diseases but for new diseases like cholera this theory of met me as it is i'm actually can make things much worse so for example in the city of london people have started installing flushed water closets as they call them are what we know as flush toilets and they do this because they thought to be healthy that you would get rid of the these all these miasma is from human waste you get rid of all the bad smells that from your homes and your streets and you flush all this stuff away so that that would make you more healthy but since all they cared about was the smell and not the contents they didn't mind that they actually flush all of their waste directly into the river thames which was the source of their drinking water and in fact after every cholera outbreak people in the city of london would install more flush toilets to dump more of their human waste into the drinking water rather than less so the big question of course is could this happen again and i went around to different places you know into south china and hong kong and port au prince in new delhi and elsewhere trying to find where new pathogens were emerging and how this story of cholera kind of shed light on what will happen with these new pathogens and how they are what factors are driving them forward and i found is really many of the same drivers that are that pushed cholera into human populations in the one nine hundred centuries are being recreated today but on a global scale so we're invading wild habitat on a unprecedented scale and that's because our populations are growing and also our industrial activities are growing and what happens here is that we invade wildlife habitat or we disrupt wildlife habitat either way humans and wild animals come into novel kinds of contact and that allows their microbes to spill over into our bodies sixty percent of our new pathogens today are coming from the bodies of animals that seventy percent of those are coming from wildlife and a good example of that is ebola virus so a q judge of the continent of africa is being deforested right now not just because populations are growing and farms and mines are expanding it's also because of political violence those three countries on the western most point of west africa sierra leone liberia and guinea over the course of the ninety's were involved in a very complicated very violent political conflict and what happened is about six hundred thousand people refugees fled into this one area where these three countries me guinea right in the middle there where they all meet was once one of the most biodiverse force in the world it's called the guinea forest region so six hundred thousand people flee into this forest to get away from the violence and then what happened is visible from see that area that was once all green is now mostly brown only fifteen percent of that original forest remained afterwards and what we now know is that the whole area that's been deforested overlaps pretty reservoirs of ebola virus so as people started living near bats we started getting people a virus and that happened for the in west africa in the end of two thousand and thirteen a two year old child was living near the guinea forest region in a village he's known to be have been playing near a tree where bats were known to roost and so whether he was exposed to bat saliva or a bat excreta ebola virus infected him and then he infected his family members and then they infected their healthcare workers and they infected their family members and on and on until we had the biggest ebola outbreak in history over eleven thousand people died it's more than all of the previous ebola outbreaks that had occurred combined but this isn't just happening in far off places this is happening in the united states as well a good example of that is west nile virus so west nile virus is a virus of migratory birds from africa they land here by the millions have been doing that for a long time specially places like new york city which is on the flyaway that they land on but we didn't have west nile virus in humans until pretty recently because we had very diverse bird flocks and we have lots of diversity of species some of those species don't really they're not really vulnerable to west nile virus if you have lots of species like woodpeckers and rails they actually repel the virus so as long as you have all these diverse species around you don't have that much west nile virus around in your birds but what happened over the past twenty five years or so is we've lost a lot of that avian biodiversity so we don't really have a lot of woodpeckers in rails anymore well we do have is a lot of robins and crows those are birds that can live anywhere american robin populations have actually doubled in the last twenty five years and it turns out that unlike becomes a mosquito will bite an infected bird and then bite a person and pass on west nile virus and that's exactly what happened in one thousand nine hundred nine first outbreak of west nile virus in the united states and since then it has steadily spread across the nation this is a picture of all of the counties in the united states where west nile virus infected birds have been found similarly the northeastern forest when it was intact we had a diversity of woodland species we had deer and mice and we also chipmunks and possum but we started breaking that forest up into little suburban plots and when we did that we lost the a possums and we lost the chipmunks the deer in the mice they stayed they can they can live in this patchwork forest well it turns out that a possums the typical possum actually destroys about six thousand ticks a week through grooming but typical whitefoot in mouse destroys about fifty  so the fewer possums you have around and the more mice you have around the more takes you have around and the more likely an outbreak of tick borne disease becomes in people and that's exactly what happened in in the late seventy's when we had the first outbreak of arthritis in children which we now know was caused by what we know as lyme disease and that disease has also steadily spread across the country of about three hundred thousand people being diagnosed with lyme every year so we're driving pathogens into human populations through all of these new ways and then we're actually allowing them to amplify in our cities so that process of urbanization that started in color as time in the eight hundred is sort of reaching its peak now so by two thousand and thirty the majority of the human species will live in cities and they're not going to be cities like seattle and washington d c they're going to be cities more like one row via and freetown in west africa ad hoc development lots of slums not a lot of infrastructure but two billion people live in slums by then so we've already seen this kind of massive urban expansion and a new pathogens have already taken advantage of this ebola for example we've had a ball outbreak since the seventies but it had never infected any place with more than a few hundred thousand inhabitants in two thousand and thirteen when it broke out in guinea within a couple  weeks ebola reached three capital cities with a combined population of nearly three million and this is one really big reason why it was such a huge conflagration similarly a virus which i animals not people now what we see is the viruses being carried by eighty's egypt i this is a mosquito that specializes in cities and it has dramatically expanded its range as our cit especially in the american tropics have gotten so much bigger this mosquito can live in it breeds in like a bottle cap with a little bit of a drop of water in a bottle cap that's what they say eighty eight is a dip to mosquitoes can breed in that little water so they thrive in all of our plastic garbage that we leave around and i'm like those forest mosquitoes they only bite humans and so there's a big reason why spreading so explosive lee right now but we're not just crowding people together we're also crowding our animals together we have more animals under domestication nala than in the last ten thousand years of domestication until one thousand nine hundred sixty combined so a huge number of animals that were rearing for our need for protein or demand for meat and many of those animals are living in these giant factory farms where there's like a million individuals or more crowded together so they're basically living in the animal equivalent of  and these these animal slums perform the same function as our human slugs do they allow pathogens to replicate really rapidly evolve and become more variant and one example of that is is avian influen influenza normally lives in wild waterfowl doesn't really make them sick but when those viruses drop into these factory farms full of captive birds they start to spread really fast they start to mutate and they become more v and we've had an increasing problem with more and more of these novel kinds of avian influenza emerging out of these factory farms including some that can in fact humans and this of course is causing another new kind of sanitary crisis that we still have two point six billion people around the world who have no access to modern sanitation but on top of that we also have seven billion tons of animal excreta produced every year and this is far more than we can possibly use in the old way which is what we're still trying to do which is as fertilizer for crop plants but can't absorb this huge volume of animal waste and so what farmers are doing is just collecting lagoons which is pictured here is basically a unlined open pit full of animal waste and so when it rains or when there are storms this materials washes over into the environment and waste is so often it contaminating our food and water we have seventy thousand americans getting sick with this this variant form of the color every year but of course we're spreading the stuff around and you know our flight is the most efficient way of disseminating pathogens we could possibly have devised we have not just a few airports in capital cities but hundreds of airports and even in small towns and tens of thousands of connections between them all so if a pathogen emerges in one part of the world as a simulation of a flu pandemic shows can very rapidly spread across the planet and in fact our fight network is so decisive in shaping how epidemic spread that you can actually predict where and when an epidemic will next strike just by measuring the number of direct flights between infected and uninfected cities so if you run that same flu pandemic on a map like this which cities in relationship to their direct flights that connect them you can see just resolves into this perfect series of waves so there's all these ways in which modern life is pushing pathogens  and increasing the risk of pandemics but of course we are we still have all of her defenses and in fact they're much better now than they were in the past but we still have challenges to so of the biggest one hundred biggest economies in the world today only forty nine are governments fifty one are corporations and so what we find is when public health strategies interfere or conflict with industry interests we're not able to contain pathogens as best as we can one example of that is antibiotic resistant bacteria so we've known since the one nine hundred forty s at least that if we use antibiotics in a way that's not medically necessary we will encourage the emergence of drug resistant bacteria and yet in the united states today eighty percent of the antibiotics that we use are used for commercial reasons they're not used for medically necessary reasons at all as twenty nine million pounds of antibiotics every year they're using agriculture in low doses to to feed to factory farm animals and help them grow faster so we've known this is happening and we have twenty three thousand people dying of antibiotic resistant bacteria infections every year and yet we've only made that tiny as baby steps to try to contain that problem our medicine is definitely a lot better than it was in one thousand century we can really rapidly come up with  cures and vaccines and killing chemicals against insects that carry disease but i would argue that there still is a mismatch so we see a lot of these pathogens coming out animals are coming out of wildlife they're being driven through human populations through social and political factors so you would think of them that the best way to tackle this problem is through a collaborative approach multidisciplinary approach get the wildlife biolog which is to kind of reduce this complex problem to its tiniest tiniest aspect and then attack those with sort of surgical precision an example of that is dangling in florida so dang you viruses a mosquito virus first emerged in florida in two thousand and nine hundred being there in seventy years and it was immediately attacked in according to the biomedical paradigm which is isolate the insect isolate the virus and zap it with killing chemicals and that's what we did but of course florida has been surrounded by places where mick for a long time the mosquitoes that carry donkey have been present in florida for a long time so there was no invasion of mosquitoes as our response would have suggested what had happened is in two thousand and eight we had the foreclosure crisis that hit florida particularly hard and so  florida there was all these abandoned homes and of course since this is florida that means there's a lot of empty swimming pools and so when the rains came these empty swimming pools filled up with standing water and they became giant mosquito notice no one was home to lead the mosquito inspectors in and lo and behold a year later we had this unprecedented outbreak of dany in florida now i don't know if addressing the housing crisis would have helped to prevent or contain the outbreak in florida because no one tried that but what i would argue is the biomedical approach has has failed in that we considered endemic in florida it's a permanent part of the landscape there so what to do this is obviously not know this right this is not a crystal ball this is not what's devil going to happen this is a prediction of what will happen spin actually and then as people either die or get sick or get immune it starts to collapse right now the earliest that we start to attack these outbreaks is around there and that's at best so for the b epidemic in west africa we actually got most of the effort was put into place after the peak of that epidemic but the best we can do is right there but at that point we already have exponential growth of untreatable disease so what if you push that back to there and start to detect these things before they start to spread exponentially and that's possible now so we don't know where the next pathogen will emerge but we do know how it happens and since we know how it happens we can predict where it's most likely to happen so this is a map of hotspots of where new pathogens are most likely to emerge these are places where there's a lot of biodiversity in people invading wildlife habitat rapid urban expansion lots of slums lots of intensification of agriculture lots of flight connections or some combination of all of those things so in those places we can do active surveillance for looking at microbes and seeing if they're changing in ways that could allow them to spread in human populations and when we find them we can start to contain them and stanch them before they stop on a flight and this is actually happening in an ad hoc way right now with ngos in academic groups and some state governments actually involved in this work of doing this active detection active surveillance looking for microbes and how they might be changing and of course there's a lot of things we can do a citizen so you know there's things we should do to be responsible in this age of pandemics we have to all take care that we're not going to be part of the problem spreading contagions i think really the most important thing is that we need to be informed the big the big missing element in our global health response from what i can see is public and agent you know we really have left this whole business up to our by a medical establishment and we haven't become involved as citizens and i think that really needs to change so ultimately what this story of pandemics has taught me is that human health is really connected to the health of our animals the health of our wildlife the health of our societies the health of our ecosystems and i think once we begin to see that we can start to actually prevent pandemics from occurring at all we can do things like restore wild habitats so that the microbes and animals stand in a ml's and don't spill over into our bodies we can do things like protecting the health of the most vulnerable among us people who live in s animals live in factory farms people who don't have access to sanitation and water and health basic health care these are all things we can do that i think put together can dramatically  i thought i was going to be the last speaker that had me really worried because i was once at a conference and i was the second last speaker and so came my turn and i started my talk and i looked out  saw one person over there the rest of the place was empty well i continue but by talking talking talking talking finally i looked over at that person and said i'm really glad you came to my talk can you tell me why you so i want to talk about something that hasn't been addressed so far today which is our health not health care but our health and i worked for thirty five years as an e r doctor and the easiest diagnosis for me to make in the e r was somebody whose did so i'm kind of focused on mortality rates whether you're a live or dead as being an important measure of our health and i want to ask i want to poll you now and see if we look at our life expectancy it's how long we live at the mortality rates using as a standard the united nations human development report will take to two thousand and fifteen report that reflects on data into thout two thousand and fifteen report reflecting on data in two thousand and fourteen so if we take the countries from cable one scott all one hundred eighty eight countries in the world and are and we rank them from the longest lived to the shortest word is united states stand in that list that me preface it by saying we spend three trillion dollars on health care in two thousand and fourteen that's eighteen percent of our total economy and it's almost half the world's total so i coined this term the health olympics to reflect the retinue of health were an olympic event how would we do so let's take the how long we live as a measure of our health and how many would give us the gold medal longest live country or a how many would put us in the top five how many would put a six to ten one two three four five how many would put us eleven to fifteen another few hands go up how many would put us sixteen to twenty ok quite a few hands twenty one to twenty five twenty six to thirty a few hands below thirty ok below thirty has it if you take the countries of the world and rank them from the longest lived to the shortest we rank behind thirty four other countries which includes all the other rich countries countries like cuba slovenia malta israel israel is really interesting it's healthier than we are we give the most for of all countries to israel i think they should be giving us aid to try to help us live longer so i call that the health olympics and we don't do so well the actual what i told you is not and the institute of medicine which is our highest functioning think tank in the country released a report in two thousand and thirteen with the title that says that all u s health and international perspective shorter lives poorer health it says everything in the title that's what i try to get my students to do so what did the institute of medicine's report say to do as fourth as four hundred page report it's basically talking about how we're did first how you know thank you know if you're one of these people that said they would say on your deathbed thank god i didn't live a longer life i wouldn't want that i'd rather die younger you'll be happily rewarded for living in the united states i kid you not so what did the institute of medicine report say to do the first thing was inform the public that were good first then look at healthier countries to see what they're doing that might be of use here i think that's pretty good advice so i just talked about mortality and there are many other measures one of them is happiness all things considered how happy are you right now i won't pull you but what do you think's been happening to happiness in the united states over the last forty years it's been going down i guess which gender has seen the decline we have we don't see declines unhappiness in other countries like this we're really tanking there you know if you look at the world happiness report two thousand and sixteen which came out in march it details all of this including our decline and happiness so that's the bad news so what are we go teach ins i used to go to them in the one nine hundred sixty s so this this is all about economic growth and and capitalism and whether we need to look for something else and if you think about it growth for growth sa that's what we're doing just trying to grow the economy that's the ideology of the cancer so growth for growth sake is that what we want well hopefully not the other thing about growth economic about a guaranteed income he was talking about an idea that richard nixon actually proposed in his family assistance plan in august one thousand nine hundred sixty nine and he got the legislation through the hope that would give everybody a trying to of income and the media at that time thought it was a bold new promising plan most of the media in one thousand nine hundred sixty nine were in favor of this idea of giving everybody income whether they were too hard for  or not so we really are the united states of amnesia we don't remember the values we used to have not in the not too distant past so what are we going to do about this what do we want and i would say we have a choice between charity or solidarity that's really really important here in this town we sort of worship the bill and melinda gates foundation it's providing charity it dish and that takes the potential tax revenues that we could use and decide how to spend and we let one man down there decide how to spend it and what does he spend it on mostly technology this is  lancer capitalism and i would say it's a variant of that's going to get worse as time goes on so we give bill tax breaks and yet if you look at the oxfam america report published earlier published just before tax day they highlighted how much microsoft has swirled away overseas in tax havens the same thing is true for amazon though they did put their figures there and they also said that if you look up how much we have subsidize these big industries such as microsoft and and was on an apple the government subsidies are huge and the amount of tax they pay is tiny back in one nine hundred sixty for every dollar of tax you paid corporations paid a dollar fifty now they pay less than a quarter twenty five cents for those of you who don't remember that so i think we need to rethink this idea of  having charity versus solidarity and i booked for solidarity so how are we going to get there so i'm going to talk now but what i think are really important things to do if all the heard the saw that if you give me a fish you feed me for a day if you teach me to fish than you fed me until the river is contaminated or the shoreline sees for development but you keep me to organize you teach me to organize all gather together with my peers and we will fashion our own solution we should be teaching organizing in the university we should be teaching organizing in the grade schools in the middle schools i've taken this message to middle schools in it and it comes across it really does work so what should you do well i don't know what you should do but i'll tell you what i do think it's good advice do what you love you know going to do stuff that you don't enjoy do you have skills that and finally do something you can do for a really long time that it dresses the issues that doesn't require you being paid a lot of money to do what you love do what you have skills at and do what you can do for a long time addressing the problem that doesn't require you being paid so where are we today well you know the world has changed immensely and now there's only two superpowers left in the world so who are the superpowers well one is the rich and powerful they number a couple of million maybe given ten million max who's the other superpower it's about seven billion straw it's all the rest of us all we have to do is get together and organize and mobilize our superpower status and believe me the rich and powerful can't stand up to us but we've been schooled into an idea that it's me that matters think about me when we have to think about me a boat we take the me turn it upside down it becomes a week we have to think collectively and act collectively that way so what  said i said when it comes to our health i said nothing about health care we don't have healthy lives if the standard is looking at how long we'd live other measures show the same thing we used to be one of the healthiest countries in the world in the  s when we had a very different value system in this country and were much more equal in corporations paid their share of taxes now our health status or many you know is is if you take a fifteen year old girl and yes states  chances of living to age sixty are less than a fifteen year old girl in sri lanka forget all the other rich countries they do better but our health isn't as good as a girl from sri lanka which is a country with that  percent of the people live on two dollars a day or less if you question any of these things the institute for health metrics and evaluation has all these dated you can draw these graphs you can see the sources from them  but it's the best kept secret in the united states fifteen year old boy in tunis see it as a better chance of surviving to age sixty than a fifteen year old boy here i think we deserve better health i think the whole world deserves better health than actually the health status between the highest and poorest country is actually declining so i think that there is really progress there so i've suggested that we shouldn't rely on giving  breaks to the rich and powerful so they can decide how to spend their money instead we should commandeer that money and and figure out how it would best serve us in some of the ways that jeff suggested and we've got a teacher organizing and if i leave you with the one one final we have to organize or die hi my name is nathaniel matthews trachoma stood in the department of global health here i'm also one of the founders of a group called radical public health which is a student group that looks at the root causes of many of today's public health problems i'm also member of aa do academic workers for a democratic union i want to start by kind of going off what joel said that what we're talking about today is nothing new in fact these questions have been asked for hundreds of years and i think there's a very good old yiddish proverb that speaks to this the proverb the truth never dies but is made to live like a beggar i think there are many scholars who spoke to today's issues but have fallen out of our collective consciousness and that we need to look in the past and find these scholars and find their works because many of their works are more relevant now than they were in the past when they were written  in syria on the border of turkey the kurdish liberation movement has discovered the late marie who is a vermont eco anarchists who wrote extensively about creating nonhierarchical communities and it's amazing to see that he's been discovered all the way in syria and his works i mean speak a lot to what's going on today here so i think it's long overdue that we movement cannot even bring itself to say with one voice that it is opposed to capitalism as if truly free markets green capitalism and green consumerism are sufficient means for controlling the policies of multinational corporations they talk about running workshops for corporate managers to encourage them to adopt an ecologically and ecologically sound business business ethics a left libertarian green perspective cuts through the shallow reformist and very naive thinking it states that corporate capitalism is inherently ecological sooner or later a market economy whose various laws of life is structured around competition and accumulation a system based on the dictum of grow or die of necessity tear down the planet all moral and cultural factors aside this problem is systemic not just ethical multinational corporate capitalism is a cancer in the biosphere rapaciously undermining the work of  natural evolution and the basis for all complex life forms on this planet the ecology movement will get nowhere if it doesn't directly face this fact and quote this was spoken twenty seven years ago and today it's more relevant than ever as lance mentioned we're entering the six mass extinction event on this planet permafrost melting in the arctic north this threatening to release massive amounts of carbon into our atmosphere which could exacerbate the effects of climate change this is definitely a crisis both an economic crisis and an ecological crisis but isn't that why we're here today to think of the next system i'm worried though that our our dreams will be deferred not because we didn't try but because we stopped here in classrooms workshops and conferences the time to go into the streets is now systems thinking a novel theoretical framework which i encourage people to check out i just recently discovered it was was in a large part developed by radical environmentalist named meadows and she spoke about systems as being quote unquote perverse in the sense that we try to intervene with the best of intentions but usually with the worst of results this is because we don't study systems so we instead try to interject in one specific aspect of a system so whether it's just how we consume things or just who we elect and instead we need to take a step back and look at the system in a whole something else that's very interesting is that capitalism functions as a system and our climate functions  a system systems which are currently going through what they call a positive accumulation loop so for example our climate is now gaining carbon the threatening climate change capitalism is also going through  positive feedback loop in the sense that it's isolating wealth into the hands of very few people threatening economic instability so we really need to take a step back and study systems as a whole another interesting thing is that systems don't grow linearly we like to think that but they really don't they grow exponentially there is a great french riddle that really speaks to this so imagine a pond and there's a lily in it which doubles in size each day on the thirtieth day the pond is completely consumed by the lily on what day is the pond consumed anyone twenty nine that's correct the day before it's completely consumed it's consumed and this is a harder one who knows how much of the pond is covered on the fifteenth day half way through the exponential growth this is hard the answer is point zero zero two five percent so half way through the life cycle of exponential growth the lilly is barely noticeable so we currently if we look at climate in the economy we've noticed the effects of this exponential growth we're long past the halfway point and how do we know that we're not going to go to sleep tonight and wake up tomorrow to find this pond we call home completely consumed so we are living in a crisis the crisis is now there is a thinker named thinker and writer named rebecca song that who wrote a book called paradise built in hell which talks about the importance of crises and opening up space for us to experiment in new ways of relating to each other if you look at syria and the syrian civil war we see that was a crisis that opened up opportunities for people to try to interact in the rose revolution chin's words and ways of organizing society so if we start to recognize that we're living in a crisis right now a very extreme crisis actually to crisis that they're going to converge very soon we need to realize that the time to act is now in the classrooms workshops and conferences just won't do it i got an amazing opportunity at the university of california santa cruz when i was an undergraduate to actually be part of a pretty figurative experiment the university system was starting a thirty two percent tuition increase and several hundred of us occupied administration building not just as a strategic thing but also as a way to deserve this world that we experience today and hopefully in this space that we capture create a new world unfortunately what we didn't think of is how systems function and that in order for us to have a successful movement we also have to think about growing our movements exponentially if we think about growing linearly we're not going to succeed so in this occupation we slept on tables we have to go to class and there is this constant presence of kind of police repression so we weren't thinking about how to grow this movement we're just thinking about how to defend ourselves and not get arrested i think occupy wall street also fell into the strop we need to think about reaching out to other people and growing exponentially not just sustaining ourselves and you know creating some sort of symbolic action  realize that the time to act is now it's not in the abstract future it is now in the streets as pointed out and i wanted to end with the quote from his one nine hundred eighty nine essay entitled the death of a small planet  we tend to think of environmental catastrophes such as the recent exxon valdez oil spill disaster in the bay of alaska as quote unquote accidents isolated phenomena that erupt without notice or warning but when does the word accident become inappropriate when are such occurrences inevitable disasters rather than accidents and when does a consistent pattern of inevitable disasters point to a deep seated crisis that is not only environmental but profoundly social thank you very much