The Conversation, with Eric Kostegan
In our blog series “The Conversation,” we delve into the interconnectivity between climate, health, and humanitarian crises. Meet Eric Kostegan, the Chief Development Officer of the WHO Foundation. He brings over 25 years of experience as a senior executive in various organizations such as the Climate Leadership Initiative, Mount Sinai Health Systems, Massachusetts General Hospital, and The Conservation Fund. Together, we explore how the business sector, philanthropists, and individuals can contribute to solving these global crises.
After nearly 25 years of extensive experience in the climate and health sectors, what brought you to WHO Foundation?
My realization that climate change is an immediate threat impacting human health led me to the WHO Foundation. It became evident that focusing solely on mitigation is insufficient; we must prioritize adaptation and resilience to secure a habitable planet for everyone. This highlights crucial concerns about global health systems, humanitarian crises, migration, urban areas, and ultimately, humanity’s future. The latest IPCC report outlines our path over the coming century.
At the WHO Foundation, I have the chance to address these issues directly. Our efforts go beyond emergency response; we invest in readiness and work towards constructing more robust, resilient health systems. This vital mission resonates with my passion and expertise in the field.
How do you see climate, health, and humanitarian crises as interconnected? How would you describe the relationship?
There are multiple ways in which climate, health, and humanitarian crises interconnect.
First, conflicts and global security have ties to fossil fuels, as seen in the Russia-Ukraine situation where fossil fuel and resource control are primary factors. Secondly, chronic disasters like droughts in the Horn of Africa and the Sahel, and sudden floods in Pakistan, necessitate foresight and intelligent infrastructure development that accounts for climate and environmental factors, such as air and water quality and food availability. Lastly, the burning of fossil fuels and environmental pollution result in approximately seven million premature deaths annually, with children being the most affected.
These crises render some regions uninhabitable due to heat and drought, leading to food shortages. Climate change, health, and humanitarian crises are inextricably linked, and it is imperative to address these issues collectively.
The latest IPCC report highlights that inequity, conflict, and development challenges heighten vulnerability to climate risks. How will low-income countries like those in the Sahel and Greater Horn of Africa be further exposed to these risks? And what are the potential health risks we should anticipate?
The latest IPCC report stresses that inequity, conflict, and development challenges increase vulnerability to climate risks. Low-income countries in the Sahel and Greater Horn of Africa face heightened exposure to these risks due to factors such as limited resources, fragile infrastructure, reliance on agriculture for livelihoods and subsistence, rapid population growth, and political instability. These factors make it difficult to adapt to and mitigate the impacts of climate change.
In terms of potential health risks, we should anticipate increased malnutrition and food insecurity due to climate change’s impact on agriculture. Additionally, a rise in waterborne and vector-borne diseases may occur, as changing environmental conditions become more of an enabler for pathogen transmission. Heat-related illnesses will become more common, particularly among vulnerable groups: the elderly and children. Mental health issues will increase due to stress and trauma from extreme weather events and displacement. Lastly, these climate-related health issues will strain already overburdened health systems in low-income countries, limiting their capacity to address the growing needs of their populations.
There’s an estimate that between 2030 to 2050, climate change will cause an additional 250,000 deaths each year. But we already saw with “just” 1.1 degrees Celsius warming, extreme drought has led to an estimated 43,000 excess deaths in Somalia in 2022.
How can health services better prepare to face this challenge?
The estimate that climate change will cause an additional 250,000 deaths per year between 2030 and 2050 might be too conservative, given the current impacts of global warming. To better prepare health services for this challenge, we need a comprehensive shift in our approach to healthcare delivery.
Capacity building is crucial, but it should extend beyond training traditional medical professionals. It must also involve preparing the next generation of health leaders and addressing the emerging health issues resulting from climate change. Access to data is vital for informed decision-making, and digitization should be embraced.
Localized solutions are necessary, as climate change impacts will vary from one region to another. Emphasizing local community resilience and incorporating it into healthcare programming through relevant officials and public campaigns is essential. We should empower communities to lead the response, including non-traditional healthcare providers and individuals, as most resources come from the community itself.
Technology can play a role in addressing these challenges, but it’s important to manage misinformation. Ensuring accurate information reaches the right people at the right time is critical. The World Health Organization can help by identifying effective strategies and sharing accurate information, in addition to providing medicines and other treatments, to support well-informed decision-making.
How do you see the role of WHO and healthcare service providers in preparing for new diseases that may arise due to the changing climate?
The role of WHO and healthcare service providers in preparing for new diseases due to climate change is manifold. One critical element is establishing partnerships, as no single organization can address this challenge alone. WHO can offer a global perspective, facilitate data-driven decision-making, and connect to research initiatives to understand and predict the spread of emerging health risks.
Predicting and preparing for future pandemics or epidemics is essential. Enhancing local resilience requires supporting local organizations and governments by providing accurate information, building capacity, and connecting them to a wider range of resources. Customizing training, resource allocation, and risk management based on local needs is crucial.
Decarbonization is also vital in improving overall health. For instance, in New York City’s Washington Heights neighborhood, a significant percentage of children suffer from asthma due to the proximity of fossil fuel plants and highways. This example highlights the importance of identifying and addressing hyper-local issues. Empowering local communities to prevent and treat emerging health hazards through policy changes or targeted interventions is a central part of addressing the challenges posed by climate change.
What role can the business sector play?
The business sector plays a pivotal role in addressing health and environmental risks. It is essential for businesses to recognize these risks as existential threats that can affect their employees, customers, and ultimately their bottom line.
Businesses can contribute by developing tools and solutions to safeguard their employees’ physical and mental health. A healthy, content workforce tends to be more productive, benefiting the company. Mental health is a significant aspect of overall well-being and should be prioritized by businesses.
Additionally, businesses have a responsibility to offer products and services that do not harm their customers’ health, which includes minimizing pollution and environmental hazards that pose health risks.
Taking a long-term approach to addressing health and environmental risks, businesses should consider the comprehensive impact of their operations on communities, the environment, and their employees and customers. In essence, every company is a healthcare company as they have a responsibility to protect the health and well-being of their employees and customers. By doing so, they can safeguard their financial interests and contribute to a healthier, more sustainable future for all.
What about philanthropists and individuals?
Philanthropists and individuals, often connected to the business world, wield significant influence and resources that can drive change. Philanthropy is a distinct form of capital that can be used for high-risk initiatives, unlocking additional resources and creating substantial impact. While philanthropy alone cannot resolve all societal issues, it can be strategically employed to leverage other resources.
Philanthropic efforts can encompass research initiatives without immediate financial returns, venture philanthropy drawing attention and capital to underfunded areas, or funds that help de-risk investments, paving the way for commercial capital.
Individually, philanthropists can bridge the gap between quality data and commercialization, often referred to as the “valley of death,” where venture or corporate interests are reluctant to invest. Philanthropy can provide the necessary resources to overcome this barrier.
Is there anyone else that the Foundation could collaborate with? And how can the foundation bring together different stakeholders in the health sector and beyond?
To address the second part of the question, there are already existing groups that convene stakeholders in the health sector, and the Foundation should partner with them rather than create something new. Events like Davos and Aspen gather influential individuals, and we should aim to integrate our work into these events to influence the agenda.
Regarding other potential collaborators, everyone has a role to play to some extent. Governments possess the most resources, and philanthropists can help influence their actions. However, political will is essential, requiring a constituency of citizens to support these changes. This is particularly challenging in countries like the US, where legislators need their constituents’ backing for re-election. Therefore, we should focus on uniting entities with the highest leverage and connecting them with others to develop holistic solutions instead of isolated ones. The goal is to change the system, not just one specific aspect.
If you have the power to solve one crisis, which crisis would it be?
If I had the power to solve one crisis, it would be the underlying crisis of inaction, hopelessness, helplessness, and disenfranchisement. People often assume it’s not their problem and choose to address it later, prioritizing other concerns. This mindset reflects a lack of systemic thinking around the issue. However, there are win-win situations available, and it’s not a zero-sum game; people need to recognize this.
Feelings of disenfranchisement can lead to political instability as individuals who feel they have no hope or are forgotten by the system become disengaged. Institutional baggage creates friction, making it difficult to mobilize resources and make decisions. We must shift from a scarcity mindset to one of abundance and move away from fear toward hope and collaboration. Overcoming the competitive mindset is also crucial.
Our focus should be on addressing the root causes and possessing the will to implement necessary changes, rather than relying on short-term thinking and taking the path of least resistance. Empowering disenfranchised communities and fostering political stability is essential to creating hope and long-lasting, positive change.