The heat isn't just uncomfortable: it kills. And it's the clearest signal that climate change is making the Earth a more unhealthy, dangerous place.

The health toll of climate change will come under the spotlight at this year's international climate negotiations in Dubai, known as COP28, where for the first time the meeting will feature prominent conversations about exactly how a warming planet hurts people. At the first-ever "Health Day" Sunday, and throughout the conference, world leaders, health ministers from dozens of countries, and a wide array of health organizations are expected to make the case that climate action will lead to immediate, dramatic improvements in global wellbeing.

The new inclusion of health into the climate meeting addresses an urgent need and is an important step forward, says Diarmid Campbell-Lendruma, who leads the climate change and health team at the World Health Organization (WHO).

"Our first priority is strong action to mitigate carbon emissions," he says. "That is our shared goal. We can't guarantee a livable future unless we drive down the fossil fuels that cause climate change."

The inclusion comes just after the World Meteorological Association announced that 2023 is the hottest year ever recorded.

A long time coming

Campbell-Lendruma has attended COP meetings for 20 years. At his first, in 2003, there were two health-focused attendees: him and a colleague from the WHO.

Since then, momentum has gathered, but slowly. That's at least in part because for many years, climate change was presented as a future problem, says Kristi Ebi, a climate and health expert at the University of Washington who has been involved in climate and health research for decades.

"But as science has advanced and as climate change has proceeded, it's a different world today," says Ebi. "Where we see people suffering and dying right now from climate change. And that does completely change the dynamic."

Climate change's harms have become more obvious, and dangerous, in recent years. A 2022 summer heat wave in Europe killed an estimated 60,000 people, and this year's extreme heat harmed many more.

Public health organizations are seeing a resurgence of insect borne diseases like malaria that were on the cusp of being controlled. Children born today, says Lujain Alqodmani, a doctor and president of the World Medical Association, will live every day of their lives in a world shaped by climate change–one that is hotter, with more intense weather, and harder on their developing bodies.

The negotiating documents that came from the first international climate agreement in 1992, recognized that climate change would have an "adverse effect" on human health. Twenty-four years later, the 2015 Paris Agreement followed up, recognizing the worldwide right to a healthy environment.

This year, representatives from health ministries from more than 90 countries are attending the talks. Hundreds of doctors, nurses, and other medical professionals are also in Dubai.

"This is the first true opportunity to bring the health voice to the climate community," says Estelle Willie, director of health policy at the Rockefeller Foundation, a major funder for climate and health initiatives worldwide.

How climate change hurts human health

There are many climate risks to the global health system, and those risks are growing. Extreme heat is the most obvious. But climate disasters also damage health infrastructure, like clinics and hospitals, which prevents people from getting care after disasters.

Climate change makes those disasters more intense. Unprecedented rainfall in Pakistan in 2022, for example, drove floods so voluminous they covered one third of the country, displacing millions and causing long-lasting health ripple effects. Climate change is affecting food security in many parts of the world. And it is increasing the risks of disease, sometimes in unexpected ways.

Githinji Gitahi is a doctor based in Kenya and CEO of the African Medical and Research Foundation, or Amref. In recent weeks, floods in his country have caused more than 100 deaths. The initial disaster is only the beginning of the health risk, he says, because the flooding is causing issues with water and sanitation systems.

"That means that there is likely to be a cholera outbreak in many of these areas where there was flooding," Gitahi says.

Burning fossil fuels also produces local air pollution that kills millions every year. In the U.S., particles from coal burning killed an estimated 460,000 people over 65 in the past 20 years. But deaths drop as soon as plants close or air-cleaning filters are installed. Because the health benefits start when pollution stops, cutting fossil fuel burning could save millions of lives quickly, says Sir Andy Haines, a researcher at the London School of Hygiene and Tropical Medicine.

"As we move towards clean, renewable energy, we reduce these preventable deaths from air pollution, as well as reducing the risk of climate change, dangerous climate change," says Haines.

What could happen at COP28?

The health community's priority at the UN climate talks in Dubai is advocating for a swift and complete phase-out of fossil fuel use, says Miller.

"We've got to stop making the problem worse," she says.

Such an agreement is unlikely to occur. A debate about whether to "phase out" or "phase down" fossil fuel use derailed negotiations at last year's COP27. Many oil-producing countries favor agreements that would allow fossil fuel burning to continue if "abated," or with its carbon emissions offset or captured. Simply phasing down fossil fuel use, would fail to address the particulate pollution that causes millions of deaths annually worldwide, says Miller, of the Global Climate and Health Alliance.

But continued discussion of a fossil-fuel-phase out is a priority, says Alice Bell, head of climate and health policy at the Wellcome Trust, a major funder of initiatives worldwide.

"We want something more explicit to be said about the phase out of fossil fuels," says Bell. "That was one of the things that was really watered down last year, and was really disappointing last year at COP27. And is one of the things people are really ready for a fight about this year."

Countries also need financial help to deal with the problems climate change is already causing. Less than 1% of the global funding directed toward climate change is earmarked for health issues. But on Saturday, international development banks and funds like the Green Climate Fund, as well as nonprofits like the Rockefeller Foundation, announced $1 billion in new commitments to fund health and climate-related projects. Jess Beagley, policy lead of the Global Climate and Health Alliance, wrote in a statement that the commitment is "a tremendous addition to current levels of climate and health finance."

More than 120 countries have also endorsed a declaration explicating the link between climate change and human health. It's a step toward integrating health considerations into the negotiations more formally, says Bell.

"The Paris accord in 2015 recognizes a right to health. And I think we need to see that fleshed out a bit to see what does that mean," she says.

Inevitably, that means addressing the fundamental driver of climate change: fossil fuel burning. The concept of tackling the root cause or an illness, rather than treating the symptoms alone, is both intuitive and imperative to many healthcare practitioners.

"You can't be in the business of healing people by making them sick," says Shweta Narayan, a healthcare advocate based in India who works for the nonprofit Health Care Without Harm.

It’s the pilot project of Ebb Carbon, one of several companies building a business on ocean carbon removal technology. As money pours into companies promising to take greenhouse gasses out of the atmosphere, there’s a small but fast-growing sector of startups that want to leverage one of the world’s biggest carbon sinks to clean up humanity's pollution: the ocean.

"The ocean basically provides this huge surface for gas exchange for free," says Ebb co-founder Matthew Eisaman. “We were trying to think of the lowest-cost way to do this, and you sort of naturally come to rely on Earth systems that are already happening anyway.”

The system Eisaman is referring to is the carbon cycle. Carbon dioxide in the atmosphere naturally seeps in and out of the ocean’s surface waters, but marine organisms take up some of it to build things like shells and coral skeletons. When they die, some of that carbon sinks and is stored for eons in the ocean’s depths.

But carbon dioxide also makes seawater more acidic. So much of humanity’s carbon pollution has ended up in the ocean that it’s impeding those sea creatures’ abilities to grow.

Ebb’s device neutralizes the acid in seawater and resets the natural system so it can lock up even more carbon deep in the ocean. If carbon dioxide is giving the ocean acid reflux, Eisaman says, think of this as giving it a Tums.

“Nature has shown us what works,” says Ben Tarbell, another co-founder. “If we can nudge those ocean processes and those natural ocean ecosystems, we can drive something that can scale very cost-effectively."

This system in Sequim Bay removes about 100 tons of CO2 per year, nowhere near the 1 billion tons per year that some scientists say is necessary, but Tarbell says they hope to scale up by plugging into places that already filter a lot of seawater like desalination plants.

Seashell SOS

Next to Ebb’s system, scientists at the Pacific Northwest National Lab are testing whether “enhancing ocean alkalinity,” as Ebb and others call it, could also help slow or reverse the effects of ocean acidification.

Researchers are raising shellfish in tanks and jars full of water treated by Ebb to different levels of acidification, their pH levels scrawled on pieces of red, orange and yellow tape.

It would be impossible to filter enough ocean water to undo ocean acidification around the world, but the National Lab’s Nicholas Ward says it might be possible to mitigate its effects on a local level, like in a bay where water circulates slowly.

“It’s a little early to tell,” says Ward, “but we are definitely seeing responses both in the chemistry and some of the biology.”

A solution like that would be welcomed by people like Bill Dewey. He has seen the problem firsthand, working with the Taylor Shellfish hatchery in Washington’s Hood Canal.

Fifteen years ago, shellfish populations crashed across the region and alerted many people here to the reality of ocean acidification. The state stepped in, and some hatcheries found temporary solutions. Taylor Shellfish installed a sodium carbonate pump that treats the water coming into its warehouse hatchery and keeps the pH steady.

“We’ve got a workaround, but we’re only treating 400 gallons a minute,” Dewey says, standing next to trays of oysters and buckets of geoducks. “As conditions get worse it’s going to start to affect the seed in our nurseries and the animals on our farms. I don’t want to turn my back on any potential solution at this point.”

Dewey says he hopes carbon removal can undo some of the damage climate change has done to the oceans, but as someone whose livelihood depends on the water, he says, he’s only “cautiously optimistic.”

It might not take new technology. Studies have found native eelgrass and other seagrasses could naturally act as buffers against ocean acidification. Eelgrass is endangered, and restoring its natural habitat is part of climate plans in the Pacific Northwest.

Geoengineering

When it comes to ocean carbon removal companies, there are plenty of fish in the sea. Equatic treats ocean water much like Ebb, but extracts hydrogen. Planetary Technologies also wants to dose ocean water with antacids. Brilliant Planet is farming algae and burying it in the desert.

Entrepreneurs in the space say they welcome the competition, and researchers agree the more solutions that can be safely tested, the better.

"Developing all of these early-stage approaches for marine carbon dioxide removal in parallel is critical,” says Chinmayee Subban of the Pacific Northwest National Lab.

“Hopefully we have enough technologies that we don’t get locked into any one of them too soon,” says Edward Sanders, chief operating officer of Equatic.

The White House recently set up a Fast-Track Action Committee on Marine Carbon Dioxide Removal to encourage more research and development.

But the idea of enlisting the ocean to clean up carbon pollution has a reputation to overcome. In 2012 a scientist dumped 120 tons of iron sulfate dust off the coast of British Columbia to try to spur the growth of carbon-eating algae. Canadian authorities investigated him for illegal dumping, and his experiment spurred a lot of uncomfortable questions about who owns the ocean, and whether “geoengineering” should be on the menu as a solution to the climate crisis.

“I think of that as ocean carbon dioxide removal 1.0,” says Sifang Chen, a physicist and science advisor to the carbon removal think tank Carbon180. “But then now what I think of as ocean carbon dioxide removal 2.0, they’re doing this in a way that’s trying to be a lot more responsible.”

Chen was one of 400 scientists who signed an open letter encouraging “responsible research, development, and field testing” of these ideas because she says “the ocean doesn't have to be just a victim of climate change, it can be a solution.”

But Chen says there are legitimate questions to ask as this new industry scales: What does it mean for other people who make a living off the ocean? What are the long-term ecological risks? And who is responsible for overseeing what could be a global industry affecting the whole planet? Governments should establish legal frameworks for ocean carbon dioxide removal, Chen says, and help develop monitoring tools to verify that these companies have a positive impact.

“From an investor’s vantage point, these are still fairly risky endeavors. There are really hard engineering problems that need to be solved,” Chen says. “What we need is the kind of patient capital that is going to support these types of projects without the companies feeling like they have to rush things.”

Sarah Cooley, director of climate science at the Ocean Conservancy, also supports more research but urges caution too.

“You really have to show the receipts here,” Cooley says. “Otherwise it would just be another kind of greenwash. We have a lot of climate solutions that are shovel-ready. But honestly, electrifying our transit infrastructure is not as exciting to some people as like, ‘I’m gonna put some fairy dust in the ocean and fix everything.’”

‘Fishing for carbon’

Fish Pier in Portland, Maine, has long been a hub for the commercial fishing industry. Today, it’s also home to one of the more audacious companies trying to reel in credits for ocean carbon removal.

Marty Odlin was an engineer for his family’s fishing business, fixing engines and doing electrical work out of a stall on Fish Pier. Today that stall is bustling with employees for the company he founded in 2017, Running Tide. Odlin says now they’re fishing for carbon.

“The same tools we used to fix the boats with, now we’re developing carbon removal systems with them,” says Odlin. The carbon removal system they’re most invested in is moving biomass — or, put more simply, sinking wood to the bottom of the ocean.

“As that wood is growing on land through photosynthesis, it’s trapping CO2 away into its cellulose. But when that tree falls over, dies and rots, all of that carbon goes right back in the atmosphere, and that’s the natural carbon cycle,” says Running Tide’s senior engineer Andrew Thompson. “We’re intervening, grabbing that wood before it rots and sinking it down into the deep ocean where that carbon is sequestered and locked away in the ocean.”

The company is getting its waste wood from Nova Scotia and is accounting for the carbon emissions of shipping it out to sea. In controlled experiments off the coast of Iceland, Running Tide says it has already sequestered at least 17,000 tons of carbon.

The company recently raised more than $50 million and counts Microsoft among its clients.

In Portland, they’re building high-tech buoys to test how they might be able to sink not just wood, but fast-growing algae and even pieces of rock to fight ocean acidification through the same chemical reactions at the heart of Ebb’s system.

It turns out the science of sinking things is surprisingly sophisticated. At Running Tide’s Ocean Hub, they’ve converted a former lumber warehouse into a marine science lab. Chemists in white coats pore over beakers, rows of wave tanks slosh back and forth, testing how different materials break down in the water, and outside a row of shipping containers converted into marine greenhouses are cultivating sugar kelp, sea lettuce and a smorgasbord of different algae.

Running Tide’s labs are buzzing with activity and a startup vibe that wouldn’t be out of place in Silicon Valley.

“It’s fishing, so by any means necessary to go get the job done,” says Odlin. “We’ll do whatever it takes.”

“Whatever it takes” is the ethos of many entrepreneurs in carbon removal and elsewhere who try to build businesses on early-stage science. To critics who argue carbon removal is a distraction, Odlin says companies like Running Tide are not trying to replace efforts to decarbonize the economy; that work needs to happen simultaneously, he says.

Just as early investments and research into renewable energy took decades to produce huge growth in that industry, Odlin says the world needs to start developing carbon removal solutions now if we want to have them at scale before the end of the century.

“The only thing in my head is we are not moving fast enough,” says Odlin. “We are absolutely worried about the second, third, fourth order effects. We’re doing everything we can, but the idea that we can sit back and wait and try to get it all perfect before we get after it, not gonna happen. Everyone that’s clutching pearls here, drop the pearls and grab a shovel, because there’s work to get done.”

To startups promising climate solutions on a global scale, the Ocean Conservancy’s Sarah Cooley says, “Curb your enthusiasm. There’s still a lot of time to get it right.”

“Buzz is necessary to support innovation, but the reality is that we are very far from a highly scaled-up industry,” Cooley says. “The ocean can take some experimentation, but there’s always a consequence.”

Well, that’s happening. Last month, in the city of Tracy, California, the U.S. energy secretary joined a group of very excited scientists and corporate executives to celebrate a milestone: the country’s first commercial-scale direct-air capture, or DAC, facility.

This is a template of what we need to be building across the world,” said Heirloom CEO Shashank Samala. “Just like we have solar farms and wind farms, we want carbon farms sucking up CO2 from the air.”

Heirloom is just three years old, but the company has already secured a huge investment from the federal government and a sizable boost from some of the biggest names in technology.

The direct-air capture plant in Tracy promises to absorb 1,000 tons of CO2 from the sky every year — it’s equivalent to taking about 220 cars off the road.

Carbon-hungry limestone

The technology works by taking advantage of limestone’s natural tendency to absorb carbon dioxide. Inside Heirloom’s DAC plant, towers of stacked trays rise 40 feet above the ground.

Each one of the trays is covered with a powdery limestone substance. As a breeze moves through the open-air building, the carbon in the atmosphere binds to the limestone. After a few days, robots move the trays into a kiln where a blast of heat separates the carbon from the limestone. All of it is powered by renewable energy.

But one plant is nowhere near enough, Samala says.

“These facilities need to be a thousand times larger,” he says, “and we need to build thousands of those across the world.”

A few big spenders agree. To offset its emissions, Microsoft announced in September that it would buy up to 315,000 metric tons of Heirloom’s captured carbon in a deal that cost the company about $200 million.

There’s also a lot of money from the government. The Biden Administration is investing $1.2 billion dollars in Heirloom and other companies to build direct-air-capture hubs in Louisiana and Texas.

But right now the technology is still prohibitively expensive. It costs more than $1,000 to remove one ton of CO2.

“This is like the first iPhone getting out of the assembly line,” Samala says. “If you only produced one iPhone, it would cost billions of dollars. That’s the same here. It costs over $1,000 a ton because it’s early. It's first.”

But what do you do with all the carbon once it's removed from the air? Some oil companies use carbon dioxide for something called enhanced oil recovery — a technique that pushes more polluting fossil fuels out of the ground.

Samala promises that all of the CO2 Heirloom removes from the air will be permanently sequestered, either underground or in concrete.

A ‘concrete’ solution

Storing carbon in concrete is already happening, and supporters of the technology say it reduces the environmental footprint of one of the world’s dirtiest industries.

Producing concrete for bridges, sidewalks and highways accounts for about 8% of the world’s carbon emissions. In large part, that’s because making cement — a key binding ingredient in concrete — requires heating limestone to very high temperatures.

“Concrete is the second most widely consumed material on earth after water. At the same time concrete is emissions-intensive,” says Reilly O’Hara, of CarbonCure Technologies.

The Canadian company says it has sold nearly 800 systems to inject carbon dioxide for storage in concrete across 35 countries. In November, CarbonCure announced a partnership with Heirloom, ensuring that carbon dioxide removed in Tracy will be used in nearby concrete plants.

At the Vulcan Materials Central Concrete plant in San Jose, CarbonCure's technology is already in use. Just before a load of wet concrete gets dumped into the spinning drum of a heavy-duty truck, a stream of CO2 is injected into the mix.

Carbon is not necessary to make concrete. But CO2 does give concrete a strength boost when it mineralizes in mixture, says Alana Guzzetta, who runs Vulcans’ national research lab in San Jose.

That added strength means less planet-warming cement is required in each batch of concrete, helping the company lower its carbon footprint.

“Get to zero carbon ultimately, that’s the goal,” Guzzetta says.

The concrete producers that use CarbonCure’s technology also share in the revenue from any carbon credits sold.

“Once that CO2 is embedded in the concrete, it’s there forever,” O’Hara says. “Even if the concrete is later crushed or demolished, that CO2 is permanently transformed into a rock and won’t be re-released into the atmosphere”

A distraction, or worse?

CarbonCure says its technology has already been used to lock away 379,000 metric tons of carbon dioxide in concrete.

But critics aren’t sold on the idea of sourcing the carbon from direct-air capture facilities or more traditional sources captured from polluting industrial plants.

“It’s a complete and utter waste of money,” says Mark Jacobson, professor of civil and environmental engineering at Stanford University. He argues that DAC technology “increases carbon dioxide. It increases air pollution. It increases fossil fuel mining.”

That’s because the technology perpetuates the use of fossil fuels. Jacobson says the wind turbines and solar panels needed to run thousands of new large-scale carbon farms around the globe would be much better off replacing coal-fired power plants. Add up the new pipelines or trucks you’d need to get that carbon to places like concrete plants, and it just doesn’t make sense, he says.

These direct-air capture companies are “ignoring entirely the opportunity cost, ignoring the fact you could be using that renewable energy for something much more effective,” Jacobson says. “They’re not accounting for that one bit.”

Jacobson acknowledges he is a lonely voice against a technology that global leaders say is necessary to limit the worst effects of climate change while the world weans itself off of fossil fuels.

“There is not a single silver bullet,” says Pat Sapinsley, managing director at New York University’s Urban Future Lab, a business incubator that has helped climate-conscious entrepreneurs raise $2 billion in private capital since 2009.

Yes, countries must deploy renewable energy “like crazy,” Sapinsley adds. But they should also take advantage of new technologies — and new economic opportunities — to reduce the carbon that’s already in the atmosphere.

Companies are already using new supplies of captured carbon to make diamonds, jet fuel, perfume, and yes, concrete.

“It’s a little bit like the era of the horse and buggy and somebody looking at a car and saying, ‘Oh that will never work,’” Sapinsley says. “I think it just takes some time to convince people that the future is in developing climate-tech. We need some changes in our economy.”

But almost immediately it became clear that the world was not moving fast enough to accomplish most of these 17 "sustainable development goals," or SDGs. Now, at the half-way point, with leaders once again gathered at the United Nations for its annual General Assembly meetings, multiple assessments of the SDGS – including scorecard reports by the Bill and Melinda Gates Foundation and the United Nations – find that for many of the SDGs progress has all but halted.

What does this mean for the broader effort to end global poverty? NPR spoke with Masood Ahmed, president of the Center for Global Development, a Washington think tank. (This conversation has been lightly edited for length and clarity.)

The world never really appeared on track to meet many of the SDG's. Then the pandemic hit. Where do things stand now?

The short answer is we are even less on track.

One side of it is all of these shocks the world has experienced: COVID, the war in Ukraine and its consequential impact on food and fuel prices, the increasingly visible consequences of climate change – most recently the floods in Pakistan and drought in the Horn of Africa.

But the other point here is the inadequate responses to these shocks. We've fallen even further behind than we had to because our responses have just not measured up to the need.

Among all these goals that are off-track, which is most striking to you?

The one that in some ways is most visible is the fact that until recently we were making year-upon-year progress dealing with extreme poverty. Now the consequence of the impact of COVID has been that some 100 million extra people have now fallen into poverty. So it will take a few more years to get back to where we were. And with that setback to the poverty indicator, of course, go other indicators.

Another thing I would say is that we haven't seen mass deaths from famine for a decade. The last time was in 2011 in Somalia. And this year I do think we could begin to see consequences of hunger and malnutrition and famines for the first time in ways that we really thought we had put behind us.

So it's not just that the progress is stalled. When it comes to the goal of eradicating hunger and malnutrition, the world is actually going backward?

Yes. If you look at the number of people who live at the margin of not having enough food to eat, that number has gone up over the last couple of years. And I think this year you could see the consequence of what is happening with this summer. The heat in Africa is having a huge impact on the production of food.

We are also falling behind in the race to adapt our agricultural production to deal with the future levels of heat that we're going to have to live with. One of the notable things they talk about in this year's Gates Foundation's assessment of progress on the goals, for instance, is maize, which is so important for Africa. It's almost a third of the calories that sub-Saharan Africa consumes. And if you have five days of heat over 86 degrees — which is the case often now — this is going to reduce harvests by a quarter.

I don't think we think enough about that. We are just not investing enough in R&D for agriculture. Since 2005, the United States has spent $57 billion on food aid and we've spent $9 billion on agricultural R&D. So we should be upping that.

You're saying foster a new version of what's often called the "Green Revolution" of 60 years ago?

Yes, the Green Revolution increased rice production yields all around. But it came as a result of a concerted effort of research. It didn't come about randomly. And I don't think we are investing enough globally in terms of recognizing that soon the world is going to be much hotter than it currently is. And consequently, we need to have crops that will adapt and grow better in those circumstances.

On its face, that focus on R&D makes sense. On the other hand people who specialize in famine and food insecurity always stress that there actually is enough food available in the world right now to feed everyone. They say the problem is one of distribution and pricing of food.

They're absolutely right to say that. In the immediate case, any given year when there's a famine, almost always that is because there is a distribution problem. It's actually an income problem. People don't have the money to buy the food that exists in the world now. So you're not going to solve this year's famine in the heart of Africa by growing more food. You're going to solve it by getting the food that is available over there.

The second point though, is that Africa as a continent is still importing a huge amount of food every year: 70% of the wheat they eat, they import. And why is that? It's not because they don't have the space. It's because they don't have access to fertilizers, and they don't have the right kind of investment in the varieties of crops that will grow well there and give them better yields. So they spend $23 billion a year importing food. There are 14 countries for whom there's been a very direct impact of the war in Ukraine because half their wheat comes from Ukraine or Russia.

So Africa as a continent is spending a lot of money every year on importing food and therefore is more vulnerable to shocks in the supply and the prices than it needs to be if it could invest in the fertilizers. And because of the increase in fertilizer prices this year, which have gone up three- or four-fold, a lot of farmers have cut back on fertilizer inputs. And the consequence of that is going to be sharp reductions in food production next year. What we are seeing as an immediate problem is going to spread over next year because we are not investing in fertilizers.

Another area where progress has slipped is on gender equity. For instance the Gates Foundation's report now estimates that the world will not reach gender equality until at least 2108 — three generations later than previously projected. What aspect of that most concerns you?

I think the biggest thing that leaps out to me is that if you think about how COVID has impacted women as opposed to men, what we find is that in many countries the impact can be disproportionately borne by women. That includes small businesses that are run by women and also on women's access to the safety net that is provided by some governments – because often they're not the first recipients of the safety net funding.

You also see the health consequences. I mean the effort to reduce maternal mortality was failing already, right? It wasn't on track before the pandemic. And over the last couple of years, we've seen a lot of the basic services that women need in the health sector for sexual reproduction rights being pushed aside because the health systems have been so strained in dealing with the pandemic.

Similarly, if you think about cash transfer schemes [which involve giving cash grants directly to low income people rather than in kind aid such as food or other goods and services], you find that governments put them in, but sometimes women don't have the necessary identification to be a recipient. There's also a big crisis in childcare. This caregiving is huge unpaid, undervalued work that actually prevents women from entering the workforce. And in low income countries unpaid caregiving occupies more than half of the working hours of women.

So I would say that the responses of governments have not been sufficiently cognizant of the pandemic's disproportionate impact on women and have not built in how to ensure that women have access to the support that is being provided.

You note that the shocks of the last couple years in particular could have been mitigated with a better overall international response. What would that have looked like?

If you lived in a poor country, those governments didn't have the financing – or the help from wealthy countries – to be able to provide cash to businesses and people to help tide them over. And so for them, they could only dedicate like 2% or 3% of GDP to relieving the economic consequences of the pandemic rather than the up to 20% that the rich countries have been able to spend.

And so the inequality in terms of the pace at which people were able to get vaccinated, the extent to which their inability to work and earn income was compensated through support by their governments, was all reflected in this international response that was not adequate.

It also laid the basis for an erosion of trust. And if I want to leave you with one thought, it's that the societal manifestation of long COVID is the breakdown and erosion of trust in the international system.

Tell us more about what is behind this loss of trust? And why does it matter?

If you talk to most people in developing countries, whether they're politicians who lead the countries or business people or academics or just people in households, what they say is, "People in wealthy countries didn't care about us when we were all going through the same problem."

That's important because a world in which there is no trust in community action is a harder world to live in. When it comes to many of the things on which we need to find solutions by working together — climate is the most obvious one — if most of the people living in developing countries don't trust the system, don't think that the people in better-off countries care about their future, then it's going to be much, much harder to sit around a table and find cooperative solutions.

Part of the problem was that instead of actual support, we [in wealthy countries] came through with lots of promises that we didn't fulfill. I think that makes it worse in terms of the erosion of trust. My advice is to stop making promises and start making plans.

Should those plans still include the SDGs? Or is it time to scrap this whole approach?

There's going to be a lot of debate about this in the next couple of years. We're getting to the point where people have to say, "What do you mean by these goals?"

On the one hand it's a way of reflecting that development is multidimensional, that it's about everybody having to do a bit. And that's why we have all of these 17 goals and all the number of indicators that go with them. So in that sense, it's helpful.

But one of the problems is achieving this for all countries by a certain date: Already in 2019, it was clear that you weren't going to do that for a whole bunch of goals for a whole number of countries. And it's even more clear now, right?

The second problem is that it's very hard in a framework that covers everything to say, "Well, this is a priority and this isn't" – because everybody who's attached to a particular priority, for whatever reason, can cite an SDG in support of that.

That said, in practice, people are prioritizing certain goals. You can see that there's a lot of energy and increased funding going toward supporting the fight against climate change, for instance.

Compared to these lofty goals for 2030, the current reality looks so bleak. What's the best case scenario of how all this plays out? And how realistic do you think that best case scenario is?

Well, look, I think the next few years will be tough for many countries. We haven't talked at all about debt. Probably a third of emerging markets and two-thirds of low income countries have debt levels that are causing them severe distress or are putting them at risk of falling into a debt crisis. So that's going to be another set of issues they have to grapple with.

But I would say there are a couple of things that give me optimism. One is that the pace of scientific and technological progress is really continuing in ways that are un-remarked upon. I mean, it is worth just stepping back and remembering the fact that, with COVID, we were able to develop a vaccine faster than ever before in the history of the world.

And the pace at which people got vaccinated against COVID in middle income countries was still faster than that of any other previous historical experience in those countries. Now, I think it was shameful it was so much slower than in the rest of the world. But the technology was very good on that front.

The other thing that gives optimism is if you go around and talk to people in low income countries, what strikes me is the innovation and energy in young people who are trying to find new ways to earn a living, take advantage of the internet and do business. You also see resilience everywhere.

If you go to Asia, many young people look to the future and see more bright spots than I think we do just by reading the data. They see their lives as having opportunities. Their vision of the future often is relatively bright in their own eyes.

You know, even go to Nigeria, a country that really has a lot of difficulties. And yet you talk to young entrepreneurs trying to set up businesses in Lagos or in Abuja, and you will find that they're full of energy and enthusiasm.

It's partly our role to point out the half empty glass, right? And actually right now it's three-quarters empty. But in that remaining quarter, they have a lot of energetic young people who are trying to carve out ways to do things and make them work better.

After he harvests his corn and soybeans, he plants cover crops, which sequester carbon all winter long, on his entire 1,000-acre operation in Prairie City, Iowa. He's avoiding tilling, or plowing, his soil as much as possible, which helps keep carbon stored in the ground.

"I've kind of had a passion for conservation all my life," he says. "We've always been pushing the envelope on what we're trying to do."

Cannon is getting help to finance this climate-friendly way of farming, which costs him thousands of dollars for additional machinery and seed, from the kinds of companies that ultimately buy his product. Footing the bill in his case is PepsiCo and Unilever, which own food brands ranging from Lay's and Gatorade to Hellman's and Ben & Jerry's.

This kind of cross-supply chain partnership could become increasingly common. A consortium of 12 food companies, including Mars, PepsiCo and McDonald's, announced a plan to scale up the amount of regenerative farmland. The plan was released just days before the 27th Conference of the Parties to the United Nations Framework Convention on Climate Change (COP27) in Egypt.

While the practices regenerative agriculture encompasses are nothing new, it's becoming an increasingly popular climate change mitigation tool, especially among mega food corporations.

"I think [regenerative agriculture] has a tremendous but under-tapped opportunity to have a major impact on climate change," says Jim Andrew, PepsiCo's chief sustainability officer.

The food system accounts for a third of global greenhouse gas emissions and the private sector largely controls that system. Corporations, including Mars and PepsiCo, have made commitments to net zero greenhouse gas emissions. But the industry is inextricably tied to emissions, with an enormous, multi-million ton carbon footprint. Part of that stems from rampant deforestation. The corporate food industry also relies heavily on plastic packaging — another big source of emissions.

"They're invested in the system which generates greenhouse gas emissions, and essentially they are trapped by the need to continue to not only be profitable, but to grow their profits," says Ricardo Salvador with the Union of Concerned Scientists.

This isn't the first regenerative agriculture commitment PepsiCo has made. Last year, the company, which earned $9.7 billion over the past year, committed to converting its entire 7 million acre agricultural footprint to regenerative practices by 2030. The company says that will eliminate at least 3 million tons of greenhouse gas emissions. Most of the farmland in that footprint grows potatoes, whole corn, oats, and oranges

In its first year, PepsiCo inched only 5% of the way through that goal, enrolling 345,000 acres in its various regenerative agriculture programs.

Still, Andrew is optimistic. While he won't reveal 2022 acreage yet, he calls it "a decided step up."

The scale-up challenge

Currently, only 15% of global farmland is cared for using regenerative practices, according to the new action plan and report from the Sustainable Markets Initiative (SMI). The group says that number needs to scale up to 40% by 2030 in order to keep global warming to 1.5 degrees Celsius, as laid out in the 2015 Paris Climate Agreement. And that won't be easy, especially given the current global agriculture market.

"The commodity system tells [farmers]: Yield at all costs," says Sarah Carlson with Practical Farmers of Iowa. "And yield at all costs means that Mother Nature then pays. Climate change is her telling us: No more."

Converting to regenerative agriculture is a financial risk for farmers. It can cost tens of thousands of dollars to buy new equipment and additional seed, fuel and labor. And in its current state, the commodity crop market doesn't provide incentives to incur that cost.

"We need to invest in those farmers to de-risk that transition," she says. "I do think that companies have a huge role to play in making a big shift on the landscape."

That could manifest in a number of ways, but Carlson says one of the most effective would be to bake it into procurement contracts. In other words, the onus would be on the company to buy an ingredient (corn, rice, potatoes, etc.) only if it was grown using sustainable practices.

"That's absolutely an essential part of this plan," says Grant Reid, outgoing CEO of Mars and chair of the SMI taskforce.

The plan, while lacking in specificity, lays out five general strategies to financially incentivize farmers to transition to regenerative agriculture. The strategies range from direct payments to farmers to encouraging governments around the world to commit policy and public money.

Reid, former chief procurement officer for Mars, says another strategy is to change the way companies buy their products.

"We used to buy a spec against the quality and price," he says. "Now I think we need to have our sustainability teams and our procurement teams working closely."

Reid acknowledges prescribing any one fix across twelve of the largest global food companies is unrealistic. What works for a fast food chain might not work for a beverage corporation. And, along the same lines, what works for a rice farmer in India might not work for a corn farmer in Iowa.

"There's no one size fits all, right?" he says. "There's not one crop, one company, one country that's identical. So you can't be too prescriptive."

But that lack of precision could make it difficult to track the coalition's climate progress. Especially because there's no standardized definition of regenerative agriculture. There's no step-by-step guide or menu dictating what constitutes a regenerative farm.

"We're satisfied so far when somebody tells us that they're using a regenerative practice, say, reduced tillage or cover crops, without then asking the question: How do you know that? What is the actual, quantifiable, verifiable result?" says Salvador with the Union of Concerned Scientists.

In other words, there's no standard for how much carbon is sequestered on one acre of cover crops, for instance. That number will vary by region, crop and farmer.

"In addition to being verifiable, it needs to be permanent," says Salvador. "Because if it's not permanent, then in essence it's not really helping us with climate change."

Despite his cautionary notes, Salvador acknowledges the important role of private industry in scaling up regenerative agriculture across the food system.

Ultimately, if the world wants more farmers to farm like Will Cannon, food companies need to send those market signals. While most of his farming neighbors still look at him and his untilled ground funny, Cannon thinks that could change if the private industry keeps putting their money where their mouth is.

"As farmers, we've got to offer a bountiful crop again in the future, and I'm hopeful for the seeds that a lot of these companies are trying to plant right now," says Cannon.

The coronavirus pandemic stalled the limited progress made in the years after United Nations member states adopted the goals in 2015. Now, halfway through the 15-year time frame, not a single one of the goals is on target to be met.

“We’re at the risk of a lost decade for sustainable development,” said Guillaume Lafortune, a lead author of the report and vice president and head of the Paris office of the Sustainable Development Solutions Network, the nonprofit launched by the UN to foster and track sustainable development. “And there’s actually a risk that the gap between rich and poor countries on sustainable development might be bigger in 2030 than it was in 2015.”

The goals, which the authors described as “an ethical imperative,” cover a range of areas, including threats to the climate and environment but also basic human rights such as food, health and education.

The authors noted that goals for reducing hunger, improving health and protecting biodiversity are particularly off-track. They said changing global governance mechanisms and global finance architecture are critical for improving progress on all the goals.

Lafortune pointed to the global finance summit that opens Thursday in Paris as an important moment for the world. A main focus of the summit is how international finance can be reformed to help the developing nations that are often most vulnerable to climate change but least able to raise capital for things like transitioning to renewable energy.

The report analyzed countries’ progress on the sustainability goals by assigning them scores from zero to 100. They examined factors like poverty, hunger, disease, carbon dioxide emissions, subjective well-being scores and dozens of other indicators. Finland, Sweden, Denmark, Germany and Austria ranked highest. South Sudan ranked lowest, followed by the Central African Republic, Chad, Yemen and Somalia.

Lafortune called particular attention to the “disappointing” United States scorecard, which he said was below average for developed countries. He said the U.S. was one of the worst performers in terms of its commitment efforts and was one of only five member countries that did not present action plans and priorities to the international community. But Lafortune did note that some U.S. cities voluntarily provided local reviews.

Kimberly Marion Suiseeya, an associate professor of political science and environmental policy and culture at Northwestern University who did not work on the report, said that while she sees pressing global development shortfalls on issues like the climate emergency, she thinks the Biden administration is taking climate seriously. She also saw signs of optimism in China’s progress on renewable energy. Though the country ranked below the U.S. in the report, it has invested more in clean energy, according to research firm BloombergNEF.

Anita Ramasastry, a law professor and director of the Sustainable International Development graduate program at the University of Washington, said she wasn’t surprised that the sustainable development goals are off track. Ramasastry, who had no part in the report, said she doesn’t think many governments with more advanced economies, like the U.S., have embraced the goals or made them relevant to citizens’ daily lives.

She questioned whether the goals were overly ambitious and added that it will be important to examine how the 2030 agenda is financed, as well as the role of the private sector.

“Business has been asked to fill a role. And I think there’s just an ultimate question, which is should we have asked business to fill that role?” she asked. “Because ultimately the SDGs are meant to be about governments and states.”

The report made the same point repeatedly, singling out several “basic failures” in global governance. Those included voluntary implementation of the goals with no enforcement mechanisms when countries fall short, international trade and finance rules not geared to sustainability, and national governments not coordinating well with smaller units of government on the goals.

Lafortune called for countries to keep the sustainable development goals in mind as they approach the Paris summit and other global conferences. He said Paris has the opportunity to act as an “accelerator” toward reforming international institutions like the International Monetary Fund and the World Bank, which he sees as possible elements of a global strategy for investment in tackling climate change and other sustainable development goals.

“Despite all the fragmentation right now in geopolitics, the many crises and so on, we still need to keep that sort of long-term vision and this idea of multilateralism and global cooperation alive. I think this is absolutely crucial,” Lafortune said. “I don’t think the world will be better off if we just forget about these goals because we won’t achieve them."

It's one of the most difficult choices a community can make. Local governments typically want more housing, not less, because budgets are generally funded by the property taxes from those homes. At the same time, a nationwide housing shortage is creating even more pressure to build.

"[If] you're a local government, of course you want to develop," says Katharine Mach, who studies climate change and housing at the University of Miami. "You're building a community. You're supporting livelihoods. You're supporting tourism oftentimes. [And] there's the pragmatic dimension of, you need the property taxes."

As a result, putting limits on homebuilding can feel like a non-starter for the local officials who generally control land-use decisions.

But with often deadly extreme-weather disasters on the rise, the problem can no longer be ignored. In the last five years, floods, wildfires, severe storms and droughts have caused more than $580 billion in damage and killed hundreds of people. And some states are passing laws that put conditions on future growth.

NPR visited three places that are grappling with the question of how to stop building homes in harm's way — with varying degrees of success. Whether it's flooding, wildfires or drought that threatens a community, similar conversations are now playing out across the United States.

California: Building homes in places that could burn

Two things are painfully apparent for many California cities: the massive statewide housing shortage and a growing danger from wildfires.

With some of the most expensive housing in the U.S., California's cities face requirements to build more housing to boost supply. But where to put it is tricky. About one-quarter of California is at high risk of burning, according to state wildfire authorities. And as the climate gets hotter, tens of thousands of homes have been lost in destructive wildfires in the last five years alone.

With few statewide regulations, navigating housing needs and wildfire risk falls to local governments, like Santee, Calif., a largely suburban town on the outskirts of San Diego.

Santee is nestled next to miles of open space, and at the edge of town, a major new development of almost 3,000 homes, known as Fanita Ranch, is being planned. For years, residents like Van Collinsworth have fought the project, which would be tucked away in the golden, shrubby hills. As a wildfire inspector by day who examines flammable brush, he knows the city is at risk. It barely escaped the 2003 Cedar Fire, which destroyed more than 2,000 homes.

"I don't think the project should be built — that's the bottom line," he says. "I don't think developers and decision-makers are willing to acknowledge that we are living in a new era of extreme weather and really grapple with what that means for the desire to build and build and build."

Collinsworth directs Preserve Wild Santee, an environmental group that joined several others to file a lawsuit to stop the development after the city approved it in 2020. A judge agreed, finding that the developer didn't adequately analyze how long it would take residents to evacuate during a fire or whether they could do so safely.

The developer, HomeFed Corp., proposed the project again in 2022, this time with a phased evacuation plan that works by zones, so neighborhoods could be cleared more efficiently. Houses would be built with fire-resistant materials and have fire sprinklers. Inspectors would check that flammable vegetation was cleared twice per year, something that would be paid for by homeowners association fees. Those funds would also ensure vegetation was cleared around the outskirts of the community, creating a buffer.

"Other parts of the country are in a hurricane zone, and they have codes and standards that say, if you build to these standards, you can go ahead and build a home," says Kent Aden, senior vice president of HomeFed. "We have all these standards for building in wildfire zones, but there seems to be a resistance to allow projects to move forward that meet or exceed those standards."

In 2023, the City Council approved the project again, with several members saying they were satisfied with the wildfire safety measures after local fire officials supported the plan.

"We tried to take everything we can learn from the fires plus even more, making it, in my opinion, the best example of what can be done to make a defensible community," Aden says.

Collinsworth and environmental groups filed a second lawsuit to halt the project, and it will be heard in court next year. It's one of several lawsuits aimed at stopping developments in California, and some of these suits were supported by state Attorney General Rob Bonta. He recently released guidance for cities about how to analyze wildfire risk.

Still, while California leads the nation in some wildfire policies, like building codes for individual homes, there are few statewide laws about making development decisions in high-risk zones. Those decisions fall to local governments alone. A bill now being considered from state Sen. Ben Allen would require developers to analyze fire behavior and create evacuation plans in cooperation with local fire authorities as part of their projects.

Previous legislative bills requiring local governments to create standards for approving housing in risky areas have failed amid pushback from the building industry.

"If we site houses and infrastructure in places better, safer, that makes it easier to keep people safe as climate change intensifies into the future," Mach says. "But it's not as if we have easy choices of just building in the safe places, because there are no places that are devoid of hazards right now."

Arizona: Limiting growth where water is scarce, with a catch

Located in a desert, cities around Phoenix are constantly facing questions of water supply — not just at water management agencies but also at city councils considering where to develop. That's because Arizona has one of the most powerful laws in the country linking water with the decision to build.

In Casa Grande, about an hour south of Phoenix, Mayor Craig McFarland knows his city's future is linked to water. Housing is already in high demand. Industry is moving into the area, with both a battery and an electric car manufacturer offering thousands of jobs near town.

"We have this huge need for workforce housing, and that workforce housing needs a place to go," McFarland says. "And so that's why all of a sudden the rush is on."

But whether that housing can be built is a question. A two-decade drought in the Southwest has triggered cutbacks to Arizona's water supply, as climate change strains the Colorado River, one of the state's biggest water sources. Underground aquifers are the state's other major water source. But in Pinal County, where Casa Grande is located, overpumping of aquifers is a big concern.

So when it comes to development, McFarland consults a map that looks like a patchwork quilt. Some parcels of land are blue, which means a water supply would be ensured for new homes. But many other parcels are white. There, developers would have to find their own water supply in order to build. State law limits growth where water is in short supply, requiring new subdivisions to show they have 100 years of water for their customers.

"Arizona is the only state in the country that requires 100 years' worth of water," McFarland says. "It's a consumer protection."

This year, regulators announced they would not be guaranteeing water supplies for new subdivisions around Phoenix, limiting future construction. That has been the situation for several years in Casa Grande.

Still, McFarland isn't discouraged. In the long term, the city is looking at water recycling and conservation. And in the short term, building hasn't stopped.

That's because developers have found a profitable workaround. Arizona's water law applies only when lots are subdivided into smaller lots for six or more homes and those houses are either sold or made available for long-term rentals. Instead, developers have turned to building short-term rentals on a single large piece of land.

Not far from the center of town, construction workers are putting the finishing touches on new single-story homes in a 331-unit development. Water supply hasn't been a barrier to building because these units will be part of one large rental project.

"We don't need an assured water supply because it's one lot," says Greg Hancock of Hancock Builders, which is constructing the project. "Although it's 331 units, it's one lot."

Casa Grande, like several other Arizona cities, has seen a boom in these "build to rent" projects. Hancock says after decades in the business, his company started building them only recently and has more than 10,000 units built or in development.

"It's been one of the greatest housing markets forever," he says. "People will not stop moving here."

But with the growth, that unaccounted-for water demand is raising red flags. Already, Arizona water regulators say there won't be enough groundwater to meet existing needs over the next 100 years.

"If you build houses and you rent them, there's no way to go back and undo the fact that they're there and people are living in them," says Kathleen Ferris, senior research fellow at the Kyl Center for Water Policy at Arizona State University.

Ferris helped write Arizona's 100-year water law four decades ago. She says its strength is that it tethers building decisions to water decisions. Back then, build-to-rent wasn't common. Now, she says, the state is reaching a pivotal moment when all water use needs to be accounted for.

"Climate change and aridification have come on so much faster than most people thought," she says. "Yes, there is still opportunity for growth, but there needs to be an understanding of the limits."

This year, Arizona legislators drafted two state bills to close the loophole, which would require rental projects to have a water supply. Both failed to pass. Some cities pushed back, saying it would limit a key way to address the housing shortage. Now, a working group convened by Gov. Katie Hobbs is examining the issue.

Still, the overriding conversation is about growth. With droughts expected to worsen, Arizona's water law is pushing cities to look at boosting their water supplies locally, whether that's through building water-recycling projects or amping up conservation.

"I used to say, 'Maybe we're at our limit. Maybe we can't build any more houses,'" says Pinal County Supervisor Stephen Miller, who works on water issues. "So now I say, 'If we're going to maintain any type of growth, we have to bring water in.'"

New Jersey: A little bit of everything adds up to a lot of flood protection

New Jersey may offer a blueprint for how to get people out of harm's way while continuing to grow and prosper economically, according to climate experts.

The marshy coastal state is a decade into a systematic statewide effort to protect residents from floodwaters. And those efforts appear to be successfully limiting new construction of homes in flood-prone areas and better protecting people who live in flood zones or are considering moving into them.

"This is an area where New Jersey is very proactive," says A.R. Siders, a climate researcher at the University of Delaware who studies climate risk and housing.

New Jersey has attacked its flooding problem from every angle. Since Superstorm Sandy devastated the region in 2012, New Jersey has passed regulations that make it harder to build new homes in flood zones. If you want to substantially renovate a home that already exists in a flood-prone area, the new rules require major upgrades to protect the house from water, such as putting the whole house on stilts or moving air conditioning units and other crucial utilities off the ground so they can survive a flood.

This year, New Jersey also passed some of the strongest flood disclosure laws in the country, which means that people who are buying homes in the state get information about whether their prospective new house has flooded in the past or is likely to flood in the future.

And the state has purchased more than 1,000 houses in the last decade through a permanent home-buyout program known as Blue Acres, which acquires homes that have flooded and knocks them down to provide more open space for floodwater.

As a result, New Jersey appears to be doing significantly better than the national average when it comes to the number of homes in flood zones, according to preliminary findings by a group of climate scientists including Siders and Mach.

That's particularly notable since New Jersey is both the most densely populated state in the country and one of the most flood prone.

The town of Woodbridge, N.J., has been on the front lines of New Jersey's strategy.

After Superstorm Sandy flooded the town, the local government decided to support home buyouts.

"[It's] not something we wanted to do, but we had to do it," says longtime Mayor John McCormac. "We didn't want to lose residents."

But it was equally unthinkable that homes would be rebuilt in places that had flooded, he says. And there were alternative ways for the town to grow economically.

Because home buyouts are voluntary, the town could move forward only if people agreed to move. McCormac remembers a town meeting he presided over in the high school auditorium.

"It was difficult. People were angry," he says. "It wasn't an easy process. You know, somebody's talking to you about moving out of their home that they've been in for 60 years. And it's their biggest investment in their life."

Similar conversations have played out across the state in recent years, says New Jersey's chief resilience officer, Nick Angarone. "These are very complicated and very difficult conversations to have," he says. "You're talking about some of the basic principles of the country, you know? Where and what you can do with your property."

But unlike in other states, New Jersey residents who are considering a home buyout are assigned a case manager who can help navigate both the paperwork and the emotions that come along with such a momentous decision.

"Our case managers are sort of our secret sauce," says Courtney Wald-Wittkop, who runs the Blue Acres program. "They're very good about developing that rapport and relationship with the homeowners."

One reason New Jersey is able to match people up with experienced case managers is that, unlike other state buyout programs, Blue Acres exists all the time, not just after major disasters. Because it's permanent, it's more accessible to both homeowners and local officials, without whose support buyouts cannot happen.

Ultimately, more than 180 homeowners in Woodbridge decided to accept buyouts and move away, says McCormac, the mayor.

The homes that remain in flood-prone areas of Woodbridge are subject to New Jersey's new, tighter regulations that require them to be elevated. Instead of building new homes in marshy areas, Woodbridge is allowing more units to be built in denser parts of town near train stations and highways. The town's population is stable, and its economy is growing.

The town's flood plain manager, Tom Flynn, says the strategy is also paying off in the form of less flood damage. When the remnants of Hurricane Ida dropped 8 inches of rain in Woodbridge in 2021, Flynn says, it flooded dozens of homes instead of hundreds.

It's not improving education. It's not wiping out poverty and hunger.

It's Goal #14 — which aims to "conserve and sustainably use the oceans, seas and marine resources for sustainable development."

A new survey of 3,500 leaders in developing countries found that marine conservation is almost universally considered the least important of the United Nations' 17 Sustainable Development Goals – essentially a checklist of priorities to help poor countries and aid organizations focus their attention on lifting the world's most vulnerable people to a higher standard of living.

Several of the goals deal explicitly with environmental issues, and the new survey, conducted by the AidData research center at the College of William and Mary, is the latest indication that these may be getting short shrift — despite oceans of evidence that protecting the environment leads to big development gains in the forms of jobs and food.

The survey respondents were asked to pick their top six priorities among the SDGs, as they're known to international development wonks. Goal #14 fared the worst. Only 5.4 percent of the respondents included it in their top six priorities, compared to 65.2 percent for quality education or 60 percent for decent work and economic growth.

The respondents included elected politicians, bureaucrats, nonprofit and humanitarian executives, and business leaders from 126 low- and middle-income countries in South and Central America, Africa, Europe and Asia. Goal #14 ranked as the least important goal in all those professional sectors, and in every region except East Asia and the Pacific, where it came in third from the bottom.

"Leaders are fairly consistent in emphasizing jobs, education and strong institutions as the most important development challenges," says Samantha Custer, AidData's director of policy analysis and the survey's lead author. "But they turn something of a deaf ear to climate change and other environmental goals."

That's not just a shame for the whales, development and marine science experts say: It's a serious missed economic opportunity. A 2015 study from the World Wildlife Fund found that oceans provide at least $2.5 trillion in goods and services every year, from fisheries to shipping to tourism. If the oceans were a country, they'd have the world's seventh-biggest economy, just ahead of Brazil. Tapping that resource, and making sure it's protected, should be a higher priority for developing countries, says Brad Ack, WWF's senior vice president for oceans.

"Oceans are a critical foundation for developing economies," he says. "People aren't drawing the connection between things they take for granted and the role oceans play in providing those services."

The survey results weren't necessarily surprising, Custer says. Last year, she conducted an analysis of development funding — how much money the U.S. government, World Bank and other major donors were spending on projects under each of the goals. Climate and environmental initiatives received significantly less funding than most other categories. Between 2000 and 2013, she found, the three goals that deal explicitly with climate and the environment together received $23.78 billion — just seven percent of what Goal #16, which deals with peace and justice, received.

Those numbers say a lot about the way rich countries and institutions prioritize challenges in developing countries. But Custer wondered if the countries giving aid might be out of step with the countries receiving it. On the contrary, she says, the new survey indicates that to a large extent they are on the same page, and that "everybody has a blind spot when it comes to the environment, apparently."

The reason, says Custer, may be that for the poorest countries, conservation still seems like a luxury that leaders can't afford when their people lack essentials like a regular supply of nutritious food and clean water.

Marine conservation, in particular, is a complex, global issue that leaders may find difficult to wrap their heads around, says Najih Lazar, a fisheries researcher at the University of Rhode Island and former U.S. Agency for International Development official in West Africa.

In fact, Lazar says, when the SDGs were being developed, marine conservation was almost axed as an independent goal and rolled into a more general umbrella environmental goal. It took persistent lobbying from marine and development experts on the potential economic and development benefits oceans can provide to convince the U.N. that the ocean was worthy of its own goal.

"It's not easy to convince a lot of people," he says. "Underwater resources are not visible, and it's not easy to understand the value in terms of economic growth. Very few have jumped on that wagon."

For that reason, he says, many developing countries leave a lot of the ocean's potential value — jobs and food — sitting on the table. But those who do make the connection stand to reap a big payoff, he says. As an example, he points to Morocco. In 2009 the country completely renovated its fishing regulations with an eye toward conservation, cracking down on illegal fishing and implementing new measures to ensure that less seafood was wasted during processing.

Since then, the country has seen employment in the fishery sector increase 30 percent and the value of its exports nearly double to $2 billion — while also seeing a revival in populations of threatened fish and octopus.

Charles Kenny, a senior fellow at the Center for Global Development, says it's important to remember that although the goals seem separate, they in fact build off each other and that more could be done to help everyone involved with implementing them — including developing country leaders and officials in donor organizations — understand the links between them.

"If you want to fix global hunger," he says, "we need to fix the oceans."

Imagine that in a moment of unusual optimism and resolve, you decided that the only way you were ever going to be the healthy, happy and productive person you want to be was by writing down a detailed list of goals and committing to accomplish them in the next 15 years.

Now imagine that eight years later, more than halfway through your 15-year life improvement plan, not only are you way off track when it comes to accomplishing most of what you committed to, but in some cases you've even slid backward. Maybe you faced an unexpected illness. Maybe you suffered a crushing breakup. Maybe you got some bad financial advice. Maybe you just didn't try hard enough.

What would you conclude? Were your goals a waste of time or would you be even worse off today without them? Should you scrap your detailed plan or double down and try to make up for lost time?

That's about where 193 world leaders at the United Nations in New York find themselves this week as they take stock of the sobering state of the Sustainable Development Goals at their halfway point along the road to 2030.

Goals are born — then run into trouble

Adopted in 2015, these goals — the SDGs — were meant to plot a course to curing 17 of the most fundamental ills afflicting human society and the planet. The first goal — SDG 1 — calls for ending extreme poverty by 2030. The second goal pledges to end hunger and malnutrition. The other 15 range across human rights and aspirations like health, education, gender equality, peace and ocean conservation. (Note: The complete list of goals is at the end of this post.)

Each of the goals comes with a list of more specific targets for countries to achieve — 169 in total. Ending poverty, for example, is broken out into a list of seven different targets, including things like creating social protection systems, ensuring equal economic rights for men and women, and delivering reliable amounts of international aid to countries in need of assistance.

The SDGs replaced the Millennium Development Goals, which expired in 2015. The new goals offered a different approach and an even more ambitious vision that applied to every country in the world, not just the so-called "developing" ones.

Then came the COVID-19 pandemic, Russia's invasion of Ukraine, global inflation and debt distress, a food security crisis and worsening climate-related disasters — what many have called a "perfect storm" of challenges that have left the SDG agenda nearly underwater.

As of this year, progress on half of the 140 targets that the United Nations is able to measure has been "weak and insufficient," according to the U.N.'s latest progress report in 2023, while another 30% have either stalled or gone in reverse . If current trends continue, 575 million people will still be living in extreme poverty in 2030, 128.5 million children will still suffer from stunting — developmental issues that result from chronic undernutrition — and 84 million children and young people will still be out of school.

There are glimmers of hope — the global under-5 mortality rate fell by 12% between 2015 and 2021. But most of the SDGs are in some variation of a similar position: slow progress, hindered by a combination of insufficient action and setbacks brought on by unpredictable global crises.

"Unless we act now, the 2030 Agenda will become an epitaph for a world that might have been," U.N. Secretary General Antonio Guterres said earlier this year.

Moment of reckoning for the SDGs

Most world leaders have responded to the grim SDG picture by recommitting to the agenda and calling for more money, stronger partnerships and greater political will to get the goals back on track.

"Now is the moment to recommit to bold and transformative change, and to do this with urgency," Linda Thomas Greenfield, the U.S. Ambassador to the U.N., said last week.

Guterres has called for an "SDG Stimulus" plan to channel $500 billion a year toward sustainable development. The White House and other allies are working to reform the World Bank so that it can lend more money to countries for health, development and climate-related investments.

But with the agenda so far off track, and in a world facing problems that leaders could not have anticipated when they adopted the SDGs in 2015, this halfway point to 2030 is also a moment of reckoning. Are sweeping international commitments to make the world a better place actually helpful in making that a reality?

"It's getting ever less and less credible that this is really a useful approach to meeting goals," said New York University Professor William Easterly, a vocal critic of top-down development planning and an advocate for humbler approaches to solving problems of poverty.

"Maybe it's useful for some other things," he conceded, noting that he was encouraged by a shift away from paternalism, recognizing that development is something done by countries, not to countries.

Then again, maybe optimism is still possible

But according to SDG advocates, those "other things" should not be lightly brushed aside.

For one, it should be meaningful that 193 world leaders got together in 2015, agreed to a set of ambitious goals, and then failed to take meaningful action to achieve them.

"Blaming COVID or Russia invading Ukraine for why we're falling behind on the SDGs is not right," said Charles Kenny, a senior fellow at the Center for Global Development.

"The reason we're falling behind on the SDGs is they were massively, massively, massively ambitious. And while we might have had the technical ability to deliver on them, we didn't follow that up with a massively, massively, massively ambitious policy agenda at the national and global levels anywhere," Kenny said.

Even though it would be a "miracle" if the world were currently on track to achieve the goals, the world's most powerful people should not be let off the hook if they made a commitment to difficult goals but then failed to try very hard to achieve them, Kenny said.

"I think we need to hold them to account," he said.

The adoption of the SDGs also marked a turning point for the U.N., said Minh-Thu Pham, a nonresident scholar at the Carnegie Endowment for International Peace, who was closely involved in the agenda's creation.

What had been an anti-poverty agenda dominated by a handful of experts was transformed into a much more open, global conversation about what people everywhere need, not just to survive but to thrive. In the transition from the MDGs to the SDGs, a much broader range of voices took ownership of the agenda, and the mindset around development shifted from one of charity to one of common aspirations.

"It was an equity agenda from the very start," said Pham of the SDGs.

For those who were present at the creation of the SDGs, the goals are a badly needed reminder that international cooperation and consensus is possible. As a permanent member of the U.N. Security Council wages war against its European neighbor, it's almost impossible to fathom that just a few years ago every U.N. member state was able to agree on what kind of world they wanted and what it might take to get there.

"You don't have to think too deeply to recognize that there was a moment of unity," Pham said. "If you're looking for a path to getting back on track for global trust between governments, between people and their governments, the SDGs remind us of that."

In other words, maybe the only thing worse than failing to achieve the SDGs would be failing to ask how we once believed they might be possible.

The United Nations Sustainable Development Goals (SDGs) to achieve by 2030:

• Goal 1: End poverty in all its forms everywhere

• Goal 2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture

• Goal 3: Ensure healthy lives and promote well-being for all at all ages

• Goal 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all

• Goal 5: Achieve gender equality and empower all women and girls

• Goal 6: Ensure availability and sustainable management of water and sanitation for all

• Goal 7: Ensure access to affordable, reliable, sustainable and modern energy for all

• Goal 8: Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all

• Goal 9: Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation

• Goal 10: Reduce inequality within and among countries

• Goal 11: Make cities and human settlements inclusive, safe, resilient and sustainable

• Goal 12: Ensure sustainable consumption and production patterns

• Goal 13: Take urgent action to combat climate change and its impacts

• Goal 14: Conserve and sustainably use the oceans, seas and marine resources for sustainable development

• Goal 15: Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss

• Goal 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

• Goal 17: Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development

"So I said, yes! Start up the microgrid! And then I texted, what is the microgrid?" Bedell recalled with a laugh.

It fell to Mick Wasco, who has been energy management director at Miramar since 2010, to explain to Bedell that Miramar was set up to run the base without using power from the city of San Diego in the case of a local or national power grid failure.

"By 2012, we started producing landfill gas electricity specifically for MCS Miramar," Wasco said, "Keep in mind, this is the size of a small city."

Using energy sources including solar and methane gas from the rotting garbage in a massive San Diego city landfill located inside the base, Miramar can go 21 days in a self-contained state that's called "island mode." Or as Col. Bedell says, aircraft carrier mode.

"I half-jokingly refer to Miramar as the USS Miramar. If you think about the installation as an aircraft carrier, suddenly the need to have redundant power to have energy-resilience, water, food-resilience makes complete sense," he said.

It makes enough sense that it's official Department of Defense policy: The Pentagon's stated goal is that all bases be "power resilient." The best path to resilience in case of a disaster is often a local renewable source, and that pairs well with another Pentagon goal — for bases to be carbon neutral by 2050. That will keep key defense capabilities intact in the case of an attack on the U.S. power grid, or more likely an extreme weather event, as climate change worsens droughts, heatwaves, wildfires and storms.

Hurricane Michael devastated Tyndall Air Force Base in Florida in 2018. The rebuild is incorporating a microgrid built for the base by the local utility.

"Florida Power & Light provides us the ability to 'island' that critical headquarters building and its functions from the rest of the installation, should there be a power loss," says Mike Dwyer, deputy chief of the Air Force Natural Disaster Recovery Division.

Getting industry partners involved made funding and building the microgrid faster than the Pentagon's normally glacial procurement process. In the next big storm, Dwyer said, the base will be able to keep up critical defense operations.

"It's designed to operate the first Air Force or Air Force's North Headquarters building completely independently for up to four and a half hours," he said.

Dwyer said Tyndall is still at least 3 to 5 years away from having a grid that could run the whole base. A Pentagon spokesperson said 90% of key bases worldwide have at least a plan on becoming energy independent, and the Defense Department currently gets 15.9% of its energy from renewable sources, and expects to be at 25% renewable by 2025.

The DoD is among the world's largest emitters of carbon dioxide, so it's exciting to see them take an interest in renewables, said Lisa Cohn with the site Microgrid Knowledge.

"The military's interest in microgrids is really, really important — because the military does tend to deploy new technologies before anyone else," she said.

The progress is mostly driven by the fact that it makes tactical sense. It can save soldiers' lives at war. Producing energy on base means trucks don't have to haul in fuel for generators to power bases in war zones, a vulnerability that proved deadly in Afghanistan and Iraq.

Brandon Newell was a Marine artilleryman in 2003. He remembers rushing north from Kuwait into Iraq, only to run out of fuel.

"It was about speed and agility and moving fast to attack Baghdad. We outran our logistics and it was ... a pause for four days sitting on side of the road so that our logistics could catch up," he said.

That experience marked him. Newell first spoke to NPR in 2011 at a remote combat outpost in Helmand, Afghanistan where he was setting up small-scale renewable power for the Marine Corps.

Newell says the troops don't really care if it's a carbon-neutral solution — as long as it helps them fight and survive. In Afghanistan, resupply convoys hit by roadside bombs were making up a huge share of U.S. military casualties.

"We have these distributed forces that are constantly requiring bullets, band aids, food and fuel," he said, "These huge convoys make you even more of a target."

Newell retired as colonel, and started a company promoting the mobile combat energy solutions he says will be even more important in the next war. He spent his last years in the Marine Corps helping stand-up the microgrid at Miramar Air Base.

Miramar is also demonstrating how microgrids in the military can make the civilian power-grid more resilient. It can provide a working headquarters during storms or heatwaves for the state or the Federal Emergency Management Agency (FEMA), according to Col. Bedell.

"Our ability to be able to continue to operate and provide that base from which we could help the local community or the state is really important," he said.

It makes sense for every state to have disaster-resilient grids on military bases, he said, and Miramar has already helped out. During a heatwave in 2022, the state energy grid was under the heaviest load in California's history. This time, Bedell got a surprise text from San Diego Gas & Electric asking if Miramar could go off city power to reduce the load and avoid outages.

"At the request of SDG&E, we turned on the micro grid to support our own utility requirements during peak hours for 10 days in a row. And that that prevented about 3,000 homes from having to go into potential blackout," said Bedell.

The Navy even "unplugged" its docked ships from the city's power grid to help.

While the military tends to focus on the use of microgrids against tactical threats, Bedell says climate change itself is also one of those threats.

"We need to be part of this solution. And if we are negatively impacting the climate change that is causing societal disruption, that's not working ourselves out of a job. That's creating the problem that we're wanting to solve," he said.