Our presentation will focus on the importance of resilience in an age of pandemics. Resilience, by which we mean the capacity to recover quickly from challenges, has always been important at an individual level, a community level, a national level and an international level. But the importance of resilience has been placed in stark relief by the COVID-19 pandemic. The pandemic showcased how events that occur in one area of the world can have profound reverberations across the planet. And it illustrated that we are not well prepared for the challenges that lie ahead.
Back in 2017, my husband Jim Stone and I sponsored a conference entitled “Ready Together: A Conference on Epidemic Preparedness”. The conference was organized by a non-profit we have been involved with for many years – Management Sciences for Health (“MSH”). The conference invited leaders from a broad range of sectors to discuss “the state of the world’s readiness to fight the next epidemic or pandemic”. Throughout the day speakers underscored the importance of preparedness and international collaboration. MSH and others had been sounding the alarm for years, letting us know that we were nowhere near prepared – not as a community, not as a nation, not as a world. And yet, here in the midst of a global pandemic, we are still ignoring so many of the issues that caused this pandemic to spiral out of control. As could have been predicted, the hardship and devastation of this pandemic has disproportionately affected the most marginalized and vulnerable in our world – those without access to healthcare, those living in poverty, and children whose lives and educations have been disrupted in consequential ways.[1]
There is so much to be done to repair the damage the pandemic has wrought and to address the vulnerabilities it has exposed and contributed to – insufficient educational systems, inequities of health care, poverty, and more. And there is an enormous task ahead to prepare the world for the next pandemic. But we owe it to our children and our grandchildren to treat this time as a watershed moment, to do more than merely return to our work with a renewed sense of purpose. For it is the children who will live with the consequences of the choices we make today. Philanthropy can help fill the gaps that governments overlook, but philanthropy and governments must see pandemic preparedness about being much more than just public health. Environmental sustainability and economic inequality are two issues my husband Jim and I are passionate about, and they are both critical to address as we prepare for future pandemics.
Scientists have suggested that there is an undeniable link between climate change and an increase in potentially lethal viruses that jump from animals to humans.[2] The reasons for this are simple to understand, but have yet to be widely appreciated by the general public. First, the warming of our planet due to human activity, and the destruction of habitat, also due to human activity, bring more animals into contact with one another and with humans.[3] More contact means more chances for viruses to jump from one species to another. Second, vector-borne diseases carried by insects proliferate as the climate warms and more regions of the world become hospitable to these hosts.[4] The more places mosquitoes can thrive, the more are the opportunities for pathogens to spread from one host to another. Third, the reduction of biodiversity, by which I mean fewer species thriving on earth, can inhibit the resilience of the remaining species to fight against viral threats. Natural selection has provided plants and animals many tools for disease resistance we have not even discovered yet, and never will if we destroy their habitats. As a recent article by Pro Publica pointed out, within the United States we have seen West Nile encephalitis spread largely because of the decreasing diversity of migratory birds.[5] And the connections between climate change and pandemic risk go on and on.
So what can we do? We can begin by recognizing the extreme interconnectedness of our world. As we have heard throughout this conference, we cannot study the challenges we face in siloes. We must recognize that our planet – its flora, its fauna, its waters, its lands, and its people are connected to one another in profound ways. In his recent Encyclical focused on “Care for our Common Home”, His Holiness states that “the climate is a common good”.[6] I could not agree more. This sentiment has underscored my life’s work on behalf of the environment. I have always believed that the climate belongs to us all. His Holiness goes on to suggest that our planet and its abundant diversity is a common good that belongs to all of us but we, as a species, are causing it irreparable harm. He writes, “Never have we so hurt and mistreated our common home as we have in the last two hundred years”.[7] At the same as we have neglected our common home, we have also neglected the people who populate it by ignoring their basic needs. As the UN report from last August makes clear, human-induced climate change has reached catastrophic levels.[8] When asked about the report, Secretary-General António Guterres said we are in the midst of “a code red for humanity”.[9] Indeed we are. The changes to our climate system are now readily observable around the world. We see it in the rising seas. We see it in the intensifying storms. We see it in the melting glaciers. We must act now to reduce emissions and do everything we can to unite the world in a commitment to slow global warming.
But as we bolster our resolve to fight climate change, we must also work on a parallel plane to make the world and its people more resilient to the changes that undoubtedly lie ahead. Resilience means planning to live with higher seas and more frequent storms. It also means creating stability in the economic lives of people so they can weather life’s inevitable challenges. Actions we take today can, and will, affect the impact the warming climate will have on the earth and all those who inhabit it. The extreme connectedness of our world means that changing weather patterns, storms, fires, floods, and other environmental disasters that occur on one continent can easily cause food shortages, disease, and despair in communities thousands of miles away. It means that when homes and entire communities are washed away by the rising seas, the impacts are felt around the globe. We must act now to build more resilient communities. But this effort will require collaboration the likes of which we have probably never seen. It will require collaboration across sectors and across national boundaries. The world’s governments, academics, non-profits, and communities must come together in unprecedented ways.
One effort currently underway in Boston is the Stone Living Lab. It is a partnership based at UMass Boston that unites the City of Boston, the State of Massachusetts, the Federal government of the United States, academics from multiple universities, indigenous tribes, and a local non-profit, Boston Harbor Now, to make vulnerable coastal regions adaptive to climate change while enhancing natural and built environments. The underlying goal is to identify new ways to build more resilient communities while recognizing that the only viable way forward is for humans to live in harmony with nature, rather than at odds with it. The Lab brings together scientists, policy makers, government officials, educators, and community leaders on an even playing field to address complex questions such as: how can we protect the coastline while also protecting fragile ecosystems that are critical to a healthy planet; and how can we ensure the solutions we develop also help alleviate undue climate burdens that so often fall on the most marginalized in society?
As a “Living Lab” we bring these questions out of the siloed halls of academia and corporate R&D and into the real world by creating a user-centered, open, innovative ecosystem that engages scientists and the community in collaborative design and exploration. Climate change is upon us. But what we do today can make a difference to the world we pass onto the next generation. The Stone Foundation is committed to establishing more Living Labs focused on building resilience across neighborhoods, towns, cities and ecosystems. In addition to bolstering the resilience of our coastlines, we see the protection of large landscapes as a key part of ensuring that today’s youth inherit a more resilient and ecologically stable world. Stone Living Labs will bring together diverse stakeholders to address the economic, social, political and environmental challenges that prevent us from conserving the habitats we know are crucial to the viability of our planet.
Across the world, biodiversity is increasingly threatened by climate change. Within the United States alone, millions of miles of roads segregate landscapes and divide ecosystems while thousands of dams and barriers prevent water from flowing freely. This places enormous survival pressure on the natural inhabitants of our country – the diverse flora and fauna we rely on to keep our air and water clean, to keep the food chain intact, and to prevent the spread of disease. It is a widely accepted principle in the field of conservation biology that large, connected landscapes and waterways are absolutely essential for biodiversity. This is even more true in an era of climate change when entire species will be forced to migrate north in search of suitable habitat. Loss of biodiversity has, and will continue to be, detrimental for our planet. The natural world is knit together in symbiotic ways and major disruptions to that balance can have catastrophic implications for pest control, carbon sequestration, our food supply and more. As one of the most brilliant and passionate scientists of our century, the late E.O. Wilson, said, “Unless humanity learns a great deal more about global biodiversity, and moves quickly to protect it, we will soon lose most of the species composing life on Earth”.[10]
Future Living Labs will continue to address how to make space for all species in the midst of modern life, how to adapt farming to today’s climate realities, how to prepare for drastic changes to our water supply, and how to live more harmoniously with nature. Implicit in the work of the Lab is bringing disparate members of the community together to reach for a common goal. Jim and I firmly believe that we need to leave a more equitable and resilient world for the next generation. And as His Holiness has written, “We are not faced with two separate crises, one environmental and the other social, but rather one complex crisis which is both social and environmental. Strategies for a solution demand an integrated approach to combating poverty, restoring dignity to the underprivileged, and at the same time protecting nature”.[11]
***
I am pleased to associate myself with my wife’s remarks and honored to be included in this distinguished assembly. Let me take just a few minutes to add two points of emphasis related to my personal experiences. I served for over a decade as a director and chairman of MSH, which is devoted to serving public health needs in some of the world’s poorest countries. And I now commit a share of my time to the philanthropy that good fortune in business has permitted, concentrating on a single issue – the accelerating trend toward wealth inequality. Both activities are relevant to the current COVID-19 pandemic. The mission of MSH, as it is generally known, is to provide tangible and educational tools for avoiding unnecessary deaths in countries with limited access to those tools. At the close of my service, MSH employed 2,500 people in over 40 countries, with an annual budget of $300 million. MSH long accepted being unknown to the public; it always worked quietly, country by country, and village by village – leaving the glamour and fame to others.
Dr. Jono Quick, MSH’s chief executive then, was also my tutor on epidemics. In 2000, Jono wrote a book called The End of Epidemics. Taken by his warning, Cathy and I sponsored the conference she mentioned to focus on the message. It was clear then that the world was unprepared for what was likely to happen. And now the COVID-19 virus has brought tragedy, illness, isolation, and anxiety to many at the individual level, transformed business, and increased xenophobia at a time when bridge-building, diplomacy, and mutual respect are especially essential. In a world where transportation modes allow vectors to be carried anywhere on the globe overnight, it is hard to envision this plague and others yet unknown disappearing as threats. Our vaccines, antibiotics, and antivirals can be only a part of the defense. As you may know, I run an insurance company, so preparatory risk mitigation is a familiar discipline in my world. But preparedness has been under-employed in global public health. Isn’t it clear now that our cultures, as well as our institutions must change to provide preparedness?
My country, the United States, is in a particularly good position to protect itself and extend protection to the rest of the world. For us, though, the COVID-19 pandemic is already comparable in significance to a war. We have lost more Americans to COVID-19 than in the two World Wars, Korea, and Vietnam combined.[12] But I fear history will judge American public sentiment as having been only half-heartedly committed to fighting the battles both at home and internationally. Our bio-science capabilities today are marvelous, but too many Americans have somehow bought into the notion that to vax or not to vax is just a personal choice, an exercise of treasured liberties. It is indeed appropriate that members of a free populace can put themselves at personal risk, even to engage in imprudent risks, if they don’t harm others by doing so. It is hard to find a logic of ethics anywhere, however, to justify as a matter of solely personal choice putting innocents at risk of serious illness or monopolizing our medical resources. It is now clear that our cultural understanding of our duty to others must change.
This takes me to a last point. As one who began adulthood as an economist, I have long been interested in distributional equity. A standard high school lesson in my day proclaimed that our nation was free of the shameful inequities of Central American banana republics, European hereditary aristocracies, and ancient oriental empires. It took me only a few years, and a little learning about racial and gender disparities, to see that nothing was that simple. Now the story is clearer but sadder. Distributional equity in the United States has not only failed to march toward improvement since then, it has reversed course entirely. Today, the United States leads its peer group in income and wealth inequality. Mobility has decreased as well. And, when too much of the wealth is sequestered at the top, what mobility remains will be of diminished consequence. Inequality in family wealth is more extreme today in the United States than it has been in almost 100 years. The top 10% of Americans by income now own 70% of the country’s wealth and well more than 90% of its financial assets.[13] Those at the very summit, the top one-percent of 1%, have a combined net worth roughly equal to that of the lower two-thirds.[14] Worse, we are far from unique. The UK is right behind us on the same track, the rest of Europe only a lap behind and, ironically, Russia and China are running about neck and neck with us.
If I had more time today, I might explore with you the causative vectors for the present trajectory. On my list are the expansion of technology, globalization, the financialization of our economies, and numerous examples of pernicious public policies. I carry no brief, though, for absolute leveling within nations. As E.O. Wilson put it: “Great idea, wrong species”. But Europe in the Dark Ages demonstrated what comes of the opposite corner solution, where the monarch and the princes own everything. That solution is even easier to reject, since it gave Europe centuries of starvation, illiteracy, and stagnation. The challenge is to identify the spot between the poles where the balance is optimized for the benefit of society as a whole.
You have already heard a bit about the economic costs of extreme inequality. But the greater threat may be to democracy. It should be obvious that a degree of economic pluralism is a precondition of democracy. As equality erodes our pluralism, and the powerful exert their influence to further enhance their relative advantages, we increase citizen alienation with the process, enhancing the power of single-issue voters, haters, and the simply delusional. This is a landscape that favors the bearers of the aggressive, heroic promises that have so often preceded catastrophe. By John Rawls’s notion, a just society is one in which virtually all would sign off on its distributions pattern before knowing where on the ladder they would find themselves. Few if any nations could meet Rawls’s standard today.
If you are asking how this thesis relates to COVID-19, let me suggest two connections. Most obvious is the nexus between financial inequality and access to vaccinations and treatment. Another less discussed linkage arises when a lack of distributive justice stresses the middle classes, as is very much the case today. When middle classes prosper, their prosperity nurtures a generous cast of mind toward the less fortunate, both within borders and toward the world at large. But as the rich get richer, it is not principally at the expense of the poor who have nothing to give up. It’s the middle classes that lose out. And the consequence is that a society tends to lose its generosity towards its own poor and reduces its sense of duty to the rest of the world. This is why we are sponsoring academic progress towards understanding the causes and consequences of wealth inequality and it is why this effort has implications for all the issues we have discussed at this conference.
The longer the COVID-19 virus multiplies and mutates anywhere on the planet, the more cases and variants we will have to fight. For the sake of all, my country should be the leader in protecting the rest of the world, and especially those in Earth’s poorer countries. Were the best angels of human nature to somehow prevail, China, Russia, and the United States, with support from a few others, would override national pride and unite to cooperate in the production and distribution of data, vaccines, necessary supplies, and treatment medications. The pandemic threat, after all, does not derive – in the manner of wars – from hostilities between nations. Rather its source is a relentlessly hostile inhuman adversary. Surely the nations of Earth would all cooperate if the threat came from fiendish interplanetary invaders in flying saucers. How different are those spiky virions from enemy space aliens? I am confident that science, technology, and the passage of time shall inevitably defeat this plague, but relief would almost surely be swifter, and preparedness and resilience enhanced, if we balanced healthy competition with international collaboration. A propitious re-assessment of our deep global connectedness could speed the world’s return to health and normalcy, and open the gates to a host of longer-term benefits on other common issues among nations as a bonus.
Bibliography
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Francis. Laudato Si’ May 24, 2015.
Githeko, Andrew K., Lindsay, Steve W., Confalonieri, Ulises E., Patz, Jonathan A. 2000. “Climate Change and Vector-Borne Diseases: a Regional Analysis”. Bulletin of the World Health Organization.
Guterres, Antonio. 2021. United Nations. August 9. Accessed September 26, 2022.
Kekatos, Mary. “1 Million Have Died from COVID in the US. Experts Wonder How This Seems Normal”. 2022. ABC News website.
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Lustgarten, Abraham. 2020. ProPublica. May 7. Accessed September 26, 2022.
Pörtner, H.O., Roberts, D.C., Tignor, M., Poloczanska, E.S., Mintenbeck, K., Alegría, A., Craig, M., Langsdorf, S., Löschke, S., Möller, V., Okem, A., Rama, B. 2022. IPCC, 2022: “Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change”. Report of the IPCC, Cambridge, UK and New York, NY, USA: Cambridge University Press. doi: 10.1017/9781009325844.
Wells, Konstans, Flynn, Robin. “Managing Host-Parasite Interactions in Humans and Wildlife in Times of Global Change”, Parasitology Research (September 6, 2022) https://doi.org/10.1007/s00436-022-07649-7
Wilson, E.O. Half-Earth: Our Planet’s Fight for Life. New York: Liveright Publishing Corporation, a division of W.W. Norton & Company. 2016.
World Inequality Database. “Wealth Inequality, USA, 1913-2021”, accessed September 26, 2022.
Yonzan, Nishant, Lakner, Christoph, Mahler, Gerszon, Daniel, Castaneda Aguilar, R. Andres,
Wu, Haoyu. “Available Data and Estimates of the Impact of the COVID-19 Pandemic on Global Poverty”. United Nations. May 22, 2021.
[1] Nishant Yonzan et al., “Available Data and Estimates of the Impact of the COVID-19 Pandemic on Global Poverty”, (May 22, 2021).
[2] Konstans Wells, Robin Flynn, “Managing Host-Parasite Interactions in Humans and Wildlife in Times of Global Change”, Parasitology Research (September 6, 2022) https://doi.org/10.1007/s00436-022-07649-7.
[3] Ibid.
[4] Andrew K. Githeko et al., “Climate Change and Vector-Borne Diseases: a Regional Analysis”. Bulletin of the World Health Organization, 2000.
[5] Abraham Lustgarten, “How Climate Change is Contributing to Skyrocketing Rates of Infectious Disease”. ProPublica, updated May 7, 2020.
[6] Francis, Laudato si’, encyclical letter, Vatican website, May 24, 2015, Section 23.
[7] Francis, Laudato Si’, sec. 53.
[8] Pörtner, H.O. et al. IPCC, 2022: Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change” (Cambridge, UK and New York, NY, USA: Cambridge University Press, 2022), 3056 pp., doi:10.1017/9781009325844.
[9] António Guterres, “Secretary-General’s Statement on the IPCC Working Group 1 Report on the Physical Science Basis of the Sixth Assessment”. United Nations, updated August 9, 2021.
[10] E.O. Wilson, Half-Earth: Our Planet’s Fight for Life (New York: Liveright Publishing Corporation, a division of W.W. Norton & Company, 2016), 3.
[11] Francis, Laudato Si’, sec. 139.
[12] Mary Kekatos, “1 Million Have Died from COVID in the US. Experts Wonder How This Seems Normal”, ABC News website, May 12, 2022.
[13] Michael Batty et al. 2019. “Introducing the Distributional Financial Accounts of the United States”. Finance and Economics Discussion Series 2019(017).
[14] “Wealth Inequality, USA, 1913-2021”, accessed September 26, 2022. World Inequality Database.