Attack of the Chatbots

In the early days of ChatGPT, you had to make a conscious effort to actively seek it out. Now, AI chatbots are becoming inescapable. 

November is an auspicious month. It was in November 2022 that ChatGPT was thrust into the public domain. It was also in November (2014) when Alexa became available to the public – and she was everywhere. Remember the Alexa frenzy? You could not utter the name “Alexa” on a phone call, or in a home without snapping some random digital assistant to attention. Any parent who’d named their child Alexa rued the day. There was the unforgettable AARP meets Alexa SNL skit imagining an Alexa for old folks. Voice was all the rage. We were a nation held captive. Sadly, Alexa’s primitive chatbot-like capabilities are no match for today’s chatbots, most famously Bing, Bard, and ChatGPT. like But, like those early Alexa days, AI chatbots are becoming inescapable.

In the early days of ChatGPT, you had to make a conscious effort to actively seek it out and start prompting. Other generative AI programs like Dall-e also made you come to them. Fast forward a few months and you’re suddenly finding yourself hard-pressed to keep AI at bay. In much the same way that Alexa allowed 3rd party developers to build out multitudes of apps from shopping lists to bedtime stories, AI is following suit, building AI-enabled apps atop the major large language models.

I made the mistake of adding the Chrome extension for ChatGPT named Merlin into my browser.  Now Merlin appears (gobbling half my screen real estate) to summarize any website I’m contemplating visiting. On Expedia, you can use the ChatGPT engine as your travel agent. ChatGPT-powered Instacart can provide easy recipes. Over at Klarna, an online shopping company, you can query its ChatGPT-powered backend to “find the greatest new television set” and have a shopping dialog. Open AI, the parent company of ChatGPT, just announced 70 new plug-ins. The plug-ins were developed by third-party developers so that you never have to leave what you’re doing to access ChatGPT’s superpowers. (One caveat: you must be a “Plus” paying member of ChatGPT to access these features).

Grammarly used to do an awesome job of improving my writing by checking my grammar and punctuation. The new generative AI-powered Grammarly Go goes way beyond. It asks if want my writing shortened, made funnier, more assertive, or even whether I want to add images it can find for me.

Over at Adobe, I’m now using generative AI that’s been trained on voices to eliminate background noises (dogs, trains, dishwashers, or music in an exhibit hall) from my videos.  This week Adobe introduced its own generative AI features, dubbed Firefly that will generate images and font effects as its first salvo into the AI arena. Its model was trained on Adobe’s huge catalog of images along with openly licensed content and stuff from the public domain. Again, no heading off to an outside image creation you’re working in AI without leaving Adobe.

Google I/O, the company’s annual conference for developers, should have been called Google AI Paloozza. All of Google’s product lines were reimagined with a long-drink of AI razzle-dazzle. As demonstrated during the event, Gmail will now craft answers to your emails. Maps will provide high-fidelity views of places on your journey before you set out the door. Photos will use a magic editor so that your skies are always blue and your backgrounds are always beautiful. (Up for debate – are these deep fakes or better photos?) Docs, spreadsheets … 25 Google products in all will get an AI IV-drip from Google’s large language model PaLM 2. Again, AI is at your fingertips without ever leaving your workspace.

Merlin is a chrome-extension that summarizes websites before they’re opened.

AI Is Coming for You, Not Vice Versa

The observation here is threefold. First, Amazon thus far has missed its opportunity to make Alexa into a really cool AI product. It’s sold more than 100 million Echo devices, integrated Alexa with 85,000 smart home products, and its app store now boasts over 100,000 skills. Yet the company’s AI focus has been almost exclusively on AWS. Amazon is not developing its own large language model but licensing others. But ‘come on. Wouldn’t it be so cool to have an AI-powered Chatbot you could talk to?

More importantly, if the past few months’ announcements of built-in AI capabilities into our everyday work tools keep up at this pace, AI will soon become a seamless part of everything we already do. You won’t have to travel to find your chatbot. It will be coming to everything, and I mean everything, near you.

And finally, the business model for generative AI has grown up (and quickly).  Licensing fees from developers, usage fees for AI-powered apps, Meta  toying with AI-generated ads, and giving away it’s model to third party developers at no charge. Experiment while you can, before the bill comes due.

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Attack of the Chatbots

In the early days of ChatGPT, you had to make a conscious effort to actively seek it out. Now, AI chatbots are becoming inescapable. 

Climate Becomes Industrial Policy, Cities Jump Onboard as EV Popularity Surges

Governments around the world are doubling down on commitments to EV mandates, incentives, supply chains, and jobs, while many cities look at how to electrify fleets and meet demand for EV charging.

With public demand for electric vehicles rising fast and an EV price war picking up steam, all signs suggest a tipping point for a technology shift that has long been expected to undercut demand for fossil fuels, reduce greenhouse gas emissions, improve air quality, and offer car owners a more affordable, convenient ride.

There are just as many reasons not to see the shift to EVs as a one-stop silver bullet to transform energy use and get emissions under control. But the federal and some provincial governments in Canada are still doubling down on their commitments to EV mandates, incentives, supply chains, and jobs, while many cities large and small look carefully at how to electrify their fleets and meet demand for EV charging.

The International Energy Agency (IEA) leapt into the conversation in late April with the release of its Global EV Outlook 2023, the latest in an annual series of market assessments. By then, the federal government had committed up to C$13 billion to an EV battery plant in St. Thomas, Ontario that will be Canada’s biggest factory when it goes into operation.

But in a complex, chicken-and-egg dance, where manufacturers need customers, drivers need charging infrastructure, charging station installers don’t want to get too far ahead of demand, and local regulation can be an obstacle, cities play an important role in either accelerating or impeding the transition.

Cities and Towns Push for EV Charging

Generous EV incentives have long made two provinces the epicentre of Canadian EV sales. In March, the Globe and Mail identified Squamish, British Columbia, Vancouver, and eight metropolitan areas in Quebec as the top ten “hot spots” for zero-emission vehicle acquisition, with 4.8 to 6.9 registered ZEVs per 1,000 population in 2022.

But other communities aren’t standing still. News headlines over the last couple of months have touched on:

• Communities like Chilliwack and Duncan, B.C. installing new EV charging stations, while a community planner in Courtenay calls [pdf] for charging stations no more than 25 kilometres apart to combat range anxiety;

• B.C. introducing new rules to ease home EV charging in stratas (condominiums);

• Canada Post rolling out its first all-electric delivery fleet on Vancouver Island;

• Calgary-based utility Enmax Power projecting a massive surge in the city’s EV use, from about 3,000 today to 200,000 by 2035;

• Local surveys that indicate growing interest in EVs in Lethbridge, Alberta, the majority of Alberta EV owners satisfied with their choice, but a northern Alberta driver cautioning that Highway 43 between Grande Prairie and Edmonton still needs charging infrastructure;

• Barrie, Ontario “playing catch-up” with other cities as it moves to electrify its municipal fleet;

• Montreal taking its place as an emerging hotspot for electric medium- and heavy-duty trucks;

• EV demand in Halifax sparking a need for trained technicians.

EVs are still seen as a largely urban opportunity, with smaller towns at risk of being left behind as “charging deserts”. But the balance is starting to shift, with analysts in Canada and elsewhere arguing that electrification is a boon to rural communities and lifestyles.

“Rural communities across the country have their own distinguishing characteristics,” wrote Maria Cecilia Pinto de Moura, senior vehicles engineer with the Cambridge, MA-based Union of Concerned Scientists, in a November, 2021 blog post. “But certain shared characteristics such as driving distances, the type of vehicles driven, and socio-economics are factors which contribute to this larger potential to benefit from vehicle electrification.”

Longer driving distances—an average 38% longer in the U.S.—amplify the savings on repairs and operating costs that city drivers are already taking away from their EVs, Pinto de Moura said. Those savings are even greater when an EV replaces a larger, older, less fuel-efficient vehicle. And rural communities are often more vulnerable to the impacts of climate change, making EVs an important source of backup power when the lights go out.

Those factors have seen the Federation of Canadian Municipalities’ Green Municipal Fund (GMF) support a community-led vehicle charging network in rural B.C., FortisAlberta launch a rural smart charging pilot, and Toronto-based Plug ’n Drive call for a “strategic approach” to EV charging in Ontario’s Bruce, Grey, and Huron counties.

“To stay competitive and relevant in attracting tourists, regions across the province must be prepared for EV drivers looking for easy access to the kinds of charging stations they want,” said Bruce Wallace, president and CEO of the Bruce-Grey area’s Nuclear Innovation Institute. “The charging infrastructure needs to be here.”

More broadly, “most small or rural communities don’t have the resources or population to support public transit or other forms of alternative transportation, so residents and visitors rely on personal vehicles for travel,” the GMF added in a project case study for its project in B.C.’s Kootenays region. “In this context, building a charging network to support a shift toward electric vehicles was the region’s best bet to reduce GHGs while bolstering the local economy through tourism and increasing the adoption of electric vehicles.”

Soaring EV Sales, Exponential Growth

For the Paris-based International Energy Agency, those local factors combined with financing and industrial development add up to exponential growth in global EV sales continuing through the end of the year. The IEA’s 2023 outlook concluded that:

• EV sales exceeded 10 million last year, and are expected to hit 14 million in 2023, for a torrid 35% annual growth rate that is expected to accelerate in the second half of the year. Those vehicles cut greenhouse gas emissions by 80 million tonnes of carbon dioxide equivalent (CO2e).

• EV spending topped US$425 billion last year, a 50% increase over 2021, and only one-tenth of the money traced back to government subsidies—the rest came from car buyers.

• By 2030, the IEA projected EVs will account for more than one-third of all new car sales. The agency’s previous outlook put that figure at just 25%.

• China accounted for about 60% of EV sales last year and has already blown through its 2025 target for “new energy” vehicle sales. EV sales increased by more than 15% in the European Union last year, accounting for one in five new vehicle sales. U.S. sales grew 55%, for an 8% share of all sales. Both the EU and the U.S. “have passed legislation to match their electrification ambitions,” and the IEA also tracked emerging EV markets in India, Thailand, and Indonesia.

• Electric two- and three-wheelers already outnumber cars in emerging markets and developing countries, offering affordable access to the mobility people need. “Over half of India’s three-wheeler registrations in 2022 were electric,” the IEA wrote, “demonstrating their growing popularity due to government incentives and lower life cycle costs compared with conventional models, especially in the context of higher fuel prices.”

• The number of EV models available around the world hit 500 last year, more than double the number on the market in 2018.

• Even if countries adopt no new policies to encourage EV adoption or rein in climate change, the IEA sees oil demand from road transport peaking in 2025, then declining by more than five million barrels per day by 2030. By the end of this decade, EV use drives down global climate pollution by 700 million tonnes.

• But a continuing cultural preference for SUVs and other big cars could offset those gains. “Last year, the growth in sales of these large, energy-intensive models nearly cancelled out the emissions reductions from record electric vehicle sales,” Carbon Brief writes. Larger models accounted for 60% of the available options in China and Europe, and an even larger share in the U.S., the IEA found.

• New battery manufacturing announced through March 2030 will be “more than sufficient to meet the demand implied by government pledges,” and would even be sufficient to meet higher EV demand under the IEA’s Net Zero Emissions by 2050 scenario. “It is therefore well possible that higher shares of sales are achievable for electric cars than those anticipated on the basis of current government policy and national targets.”

• While soaring EV sales are driving up demand for critical minerals, alternatives to lithium-ion batteries—including lithium-free, sodium-ion units—are also on the rise.

And all of these trends are likely to accelerate, with EVs on track to match the price of traditional internal combustion vehicles.

“Our current expectation is that we can see price parity in small and medium-sized electric cars in North America and European markets somewhere in the mid-2020s,” said Timur Gül, head of the IEA’s energy technology policy division. “For larger cars like SUVs and pickups, purchasing parity is likely to come later, probably into the 2030s.”

Climate Policy Is Industrial Policy

By the time the IEA released its findings, Canada had unveiled a series of budget measures that put electric vehicle development and other forms of clean manufacturing at the centre of the country’s industrial strategy. Then in April, Ottawa announced its blockbuster, $13-billion incentive package that lured Volkswagen to build a new EV battery plant in St. Thomas. The CEO of VW’s battery subsidiary, PowerCo, said the plant will be the company’s largest in North America, and possibly in the world.

“St. Thomas was the capital for trains and Volkswagen is the capital for automotive, so we fit well together,” Frank Blome said last month. “Congratulations on outperforming the competition and bringing this factory to St. Thomas.”

The VW plant was already a matter of public record, but its total cost had not yet been announced, when Finance Minister Chrystia Freeland released her 2023 budget in late March. The C$491-billion plan earmarked tens of billions for mostly clean energy technologies, including:

• An 11-year, $25.7-billion investment tax credit for clean electricity that covers 15% of investment costs for more than a dozen power generation, energy storage, and grid transmission technologies;

• A 12-year, $11.1-billion investment tax credit for clean technology manufacturing that covers 30% of project costs;

• $20 billion in redeployed funding through the Canada Infrastructure Bank for clean power and green infrastructure;

• $3 billion to renew the government’s Smart Renewables and Electrification Pathways (SREP) and smart grid programs and invest in Canada’s offshore wind potential, particularly off the Nova Scotia and Newfoundland and Labrador coasts;

• $1.5 billion for infrastructure to extract critical minerals to support battery and electric vehicle manufacturing;

• $1.4 billion over 12 years in income tax reductions for zero-emission technology manufacturers.

“While the transition to clean energy is a nation-building project that won’t be complete in one fell swoop, Tuesday’s budget builds on Canada’s pre-existing climate measures while injecting capital into a clean industrial strategy, helping secure our nation’s many competitive advantages,” Clean Energy Canada Executive Director Mark Zacharias said at the time.

The investments were enough to vault Canada to second place, behind the U.S., in public support for clean energy technology development, independent analysts at Oslo-based Rystad Energy concluded in late April. “The renewable energy investment tax credit raises the value of some projects more than 50% over their lifetime,” Bloomberg Green wrote, citing the Rystad report. “The offering of a 30% tax write-off for renewable technology deployed before 2034 pushes the country ahead of six others, including Turkey, Portugal, Vietnam, the United Kingdom, Sweden, and Germany in the support offered for green energy.”

Meanwhile, the EV mandate released late last year by Environment Minister Steven Guilbeault calls for 20% of all new cars, SUVs, and light trucks sold in Canada in 2026 to run on electricity, rising to 60% by 2030 and 100% by 2035. And Natural Resources Minister Jonathan Wilkinson is working on a mandate letter assignment to get 50,000 new EV chargers and hydrogen stations in place.

In a media explainer published last month, Clean Energy Canada traces the detailed workings of the EV mandate and compares it with similar measures in 16 U.S. states, China, and the European Union. It points to serious problems with the availability of EVs outside British Columbia and Quebec, but notes that almost all popular EV models—all except the Ford 150 Lightning—cost less to own and operate than their internal combustion equivalents.

“Almost six in ten (59%) Canadians correctly believe that an electric vehicle will end up being cheaper for them over a gas vehicle,” CEC writes, citing a December, 2022 poll. And “72% of Canadians believe that it is certain, very likely, or likely that a majority of consumer vehicles sold around the world will be electric.”

Those cost reductions are already a reality, with Tesla accused of setting off a global price war last month by slashing the price of its Model Y electric SUV below the cost of an average new vehicle in the U.S. “People who watch the industry say the Tesla move is just one indicator of a global transformation in the automotive sector, as legacy car makers learn how to make EVs as efficiently as the internal combustion vehicles that still provide most of their income,” writes CBC business columnist Don Pittis.

“Some automakers may be dragging their feet to profit—while they still can—from selling fossil fuel cars and trucks that have been cheaper to build using old technology,” Pittis added. “But once manufacturing costs equalize, the justification for producing internal combustion cars and trucks begins to disappear.”

Far from being a sign of strength, Tesla’s price move might be an attempt to grab market share while it still can, auto historian Dimitry Anastakis, a professor at the University of Toronto’s Rotman School of Business, told Pittis. “There’s going to be dozens of new vehicles that are going to compete directly with Tesla,” he said, so “Musk is really trying to lower costs.”

But with legacy automakers like Ford embracing the price competition, a number of news outlets reported that the price drop had put a damper on Tesla’s financial results, while driving down output from its gigafactory in Shanghai, China.

Embracing the Clean Energy Trade War

In her budget speech in late March, Freeland framed the package of clean economy investments as part of “the most significant economic transformation since the Industrial Revolution,” in which Canada’s major trading partners are investing heavily in the clean economy and net-zero industries. After the U.S. poured US$369 billion into mostly clean energy transition technologies through the 2022 Inflation Reduction Act (IRA), “the sheer scale of U.S. incentives will undermine Canada’s ability to attract the investments” without swift action, the budget document stated. “If Canada does not keep pace, we will be left behind. If we are left behind, it will mean less investment in our communities, and fewer jobs for an entire generation of Canadians.”

It added: “We will not be left behind.”

Less than a month later, Ottawa announced $8 to $13 billion over 10 years to attract VW’s St. Thomas plant, a massive megaproject expected to employ 3,000 people, create as many as 30,000 indirect jobs, churn out a million batteries per year across six production lines, and cover as much ground as 391 football fields, making it the country’s biggest manufacturing plant.

“This is game-changer for our nation,” Innovation Minister François-Philippe Champagne said at the time.

Leading up to the federal budget, news coverage was full of dire warnings of a looming clean energy trade war, with some EU countries objecting to the scope of the IRA incentives in the U.S. as they scrambled to keep up. Days after the VW announcement, analysts at one of Canada’s biggest banks concluded that Freeland’s incentives would keep the country competitive with the wave of investment rolling out south of the border.

The report by TD Economics “essentially refutes the arguments made in recent months by Canadian business leaders [many of them lobbying for carbon capture and storage subsidies—Ed.], who have held up the U.S. IRA as the gold standard in the global race for energy transition investment,” The Canadian Press wrote at the time.

“TD said it has crunched the numbers and the government of Canada has spent $139 billion since budget 2021, or 5% of the country’s nominal GDP, on supports for clean energy development,” CP reported. “The bank said this compares favourably to the U.S. Inflation Reduction Act’s estimated US$393-billion in spending, or 1.5% of that country’s nominal GDP.”

Which meant that, “despite criticism, Canada’s financial support for the clean energy transition is yielding positive results and has established a competitive position relative to the U.S,” wrote TD managing director and senior economist Francis Fong.

Within not very many hours of the St. Thomas announcement, Opposition leader Pierre Poilievre had asked Parliamentary Budget Officer Yves Giroux to look into how much federal money the VW plant will receive, the potential impact on jobs in other sectors, and how long it will take taxpayers to recoup the investment through increased tax revenues.

But by then, Prime Minister Justin Trudeau had already singled out a member of Poilievre’s caucus, Conservative MP Karen Vecchio (CPC, Elgin-Middlesex-London), when she attended the media conference to announce the project.,

“Karen, I’m glad to see you here and it’s great today that you and I, at least, agree on how much it matters to invest in Canadian workers,” the PM said. But “I’ll be direct and honest: You have some work to do to convince your leader Pierre Poilievre, who thinks this investment is a waste of money.”

Trudeau continued his victory lap a week later, telling an audience at the Council on Foreign Relations in New York that a number of U.S. states offered “way, way more money than we put on the table” for VW to bring its plant to their jurisdictions.

“Canada’s clean energy supply, robust social services, environmental standards, and mineral riches ultimately helped to win the day,” CP wrote, citing the PM. “Trudeau said the economic and social benefits of the facility will vastly outweigh the cost because Volkswagen is committed to being a major employer in the hard-hit manufacturing community for decades.”

“Volkswagen said, ‘OK, we’re showing up with a plant that’s not going to be there for five years, or 10 years. It’s going to be there for 50 years, maybe even more,’” Trudeau declared. “‘We need to invest in a community that is going to be invested in itself and in that future.’”

The announcement suggested a continuing appetite for industrial policy in Canada, concluded CBC senior writer Aaron Wherry—and created a careful balancing act for Poilievre.

“The most interesting thing about question period is often what’s not said,” Wherry wrote. And through the last week of April, “the Official Opposition asked not a single question” about the VW deal.

“Poilievre’s relatively restrained response could be put down to simple politics. The Conservatives might be loath to condemn something that will provide employment to people in southwestern Ontario—in a riding held by a Conservative MP, no less. The enthusiastic involvement of Ontario’s Progressive Conservative government likely also makes it harder for Poilievre to criticize the deal.”

But “perhaps the relative lack of condemnation from the Conservative side reflects a new consensus on government support for industry—what might be broadly defined as ‘industrial policy’.”

Promote EVs, Then Use Them Less

But none of that is to say that a change in private vehicle technology will deliver the emission reductions or liveable cities that many communities are trying to achieve, all on its own. Concepts like 15-minute cities are tailor-made to promote transit, walking, and biking by placing basic amenities closer to where people live, work, learn, and play. Meanwhile, developers and planners are looking at a host of alternatives to car ownership, from the e-bikes and -scooters that captured the IEA’s attention, to electric car-shares and mini-cars, to “bike buses” that get students to school and back safely and bring “sheer joy” to their neighbourhoods.

The need to reduce transportation sector emissions “intensifies with every day of inaction,” wrote Thea Riofrancos, a member of the Climate and Community Project, in an opinion piece for The Hill. But EVs are too often “presented as a silver bullet solution—stymieing more creative frameworks for getting people where they need to go and protecting communities and ecosystems from potentially avoidable mining, all while rapidly achieving zero-emissions goals.”

The “insistence on embedding current levels of reliance on personal vehicles in our future transportation system has driven eye-raising projections for global lithium demand and a rush to permit, mine, and process as quickly as possible,” Riofrancos adds, citing the IEA’s recent estimate that lithium volumes could grow 40-fold by 2040. But “expanding mass transit, walking, and cycling in addition to electrifying a reduced, right-sized U.S. EV fleet can improve people’s health and mobility, avoid bottlenecks, and broaden political support for the global green transition.”

That balance came into focus for an EV enthusiast and self-described “battery nerd” who was surprised at the mix of modes he encountered on a visit to Norway, where EVs accounted for 80% of new car sales in 2022 and 90% in Oslo, the country’s capital and largest city.

“We often hear about how Norway is an electric car utopia, an example of a country that went all in on EVs and reaped the benefits,” Micha Toll wrote in January. But that shift is seen as a step toward a sustainable transportation system, not an end in itself.

Norway “has actually begun rolling back EV incentives in favour of reducing private vehicle ownership,” Toll explained. “Walking and cycling are being promoted in big cities like Oslo to help reduce the level of traffic and energy expenditure,” and the country “has also paired policies that promote cycling and walking with a robust public transportation system.”

The net result was a visit where everything was accessible by tram or bus, electric scooters and e-bikes were “plentiful thanks to several shared micromobility companies,” and electric taxis were “readily available” but utterly unnecessary.

So “despite coming to Norway to see an electric car utopia, we ended up discovering first-hand how much more there is to the country’s story of sustainability,” Toll concluded. “And all of this is happening in a country that is so cold that I was walking around with ice on my face without even noticing. If it can work there, it can work here. Wherever here is.”

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To Transform Healthcare, Embrace Responsible Innovation

Now is the time to gather forces to focus not on short-term wins and gains but on creating enduring long-term value for all.

Healthcare has long fallen victim to hyperbolic rhetoric. We casually declare it to be “broken” when evidence to the contrary can be found in every hospital and clinic. Others say that any day now, Amazon or another big tech player is going to either rescue or destroy us, when neither is likely. And it has become a well-worn trope to call for outside “disruption” when open-minded collaboration among health system leaders, providers, and tech entrepreneurs can yield more lasting value.

As a physician and CEO of a health tech company, and a writer-anthropologist who’s spent years observing this space, we think it’s time we put these tired narratives to rest and expand our thinking. Rather than fixate on the “what” — the next big thing, trend, or government rule that will save or squash us — we should instead focus on why we need to change and identify the barriers that stand in the way. Having defined the barriers clearly — the mindsets and mechanisms holding us back — we can get to the business of solving them with a responsible approach to innovation.

To paint a picture of what responsible healthcare innovation might look like and how it can create enduring value for all stakeholders, we reached out to industry leaders for perspectives from a variety of critical vantage points. From our conversations some key considerations and principles emerged.

Understand, and solve for, the right problem

Hemant Taneja, CEO and managing director of General Catalyst (founder-investor in the company Zenooz leads) believes that to build enduring value in any industry, especially healthcare, we must reject the “false choice” between growth and good. “What that breaks down into as a framework is thinking about all the stakeholders that are relevant to your business. It means respecting people’s privacy, prioritizing equity and diversity, inclusive prosperity, and sustainability.” With this framework guiding investment and business decisions, he argues, we can then seek to align interests and solve real-world problems.

As the CEO of Chicago-based RUSH Health, one of the leading academic health systems in the country, Omar Lateef, MD has no shortage of problems to solve. For him, innovation is responsible when it is solving the right problem. “Right now, the environment in healthcare is very challenging. People are stressed. We have a labor crisis. We need people to do the work that needs to get done. The mistake that I have seen is you get very attracted by the shiny penny. And it may be that you just don’t need a penny right now.”

Rather than focus on selling the next shiny penny, tech companies should instead listen with humility, understand root causes, and tailor solutions to serve needs — even if that involves more modest enhancements to existing systems. As Lateef puts it, “everybody has a new platform, a new tool, a new something.” But health systems have made a lot of investments already and many are struggling to manage existing priorities with depleted resources. Without proper alignment, Lateef says, “we are not going to solve the challenges and the problems that we need to solve.”

Create change through “collaborative advantage”

Responsible innovation demands the opposite of a rip-and-replace approach to change, argues Taneja. “We can’t as technologists have a mindset that we’re going to go and disrupt healthcare and build a brand-new system. This is too big a problem. It’s beyond any single company. And so we have to build an ecosystem.”

Dr. Marc Harrison, an accomplished pediatric intensivist and the former president and CEO of Intermountain Health who recently joined General Catalyst, has witnessed this first-hand, including how so-called “outside experts” often miss the mark in their approach to provider organizations. “Some of the tech players can certainly come off arrogant with a disruptive ‘fix all’ approach to health systems, while some providers can be equally arrogant to assume we can ‘do tech’ without the benefit of tech leaders. Both stakeholders need each other to create the best possible outcomes for the system and the people it is meant to serve.”

The remedy to this unproductive stand-off, Taneja proposes “radical collaboration,” where investors, tech entrepreneurs, health system leaders and providers come together to solve problems with shared interests and a healthy dose of humility. At its best, such a partnership can achieve what Rosabeth Moss Kantor defined nearly thirty years ago as collaborative advantage, in which each partner benefits from the perspectives and skills the other brings to the table. Such alliances, as Kantor pointed out, yield more than just ROI; they create net new value.

At Intermountain, Harrison saw how this type of collaboration could move the needle on a problem as intractable as the transition to value-based care. With a spirit of radical collaboration, Intermountain and its tech partners stood-up a platform called Castell that “can take somebody who’s a really good doctor, or a really good clinical team, and prompt them to do what’s needed to manage the health of a population proactively.” The key to creating something that has not only achieved quality goals but improved provider satisfaction, he says, was engaging providers in the process. “You take really good well-intentioned providers with good leadership who want to make change, and pair them with a tech stack that takes the friction out and improves quality. That’s a beautiful thing.”

Such a spirit of radical collaboration is just as crucial among technology companies that typically see other vendors as competitors to be “boxed out” rather than as potential partners. The reason healthcare is so fragmented is because thousands of solutions are selling their own piece of the pie — which only adds more cost and disconnection. Responsible innovators in healthcare have the humility to know they can’t be a silver bullet for every single challenge. Any digital health company committed to driving enduring transformation should be prepared to put out the welcome mat to competitors and say: “If you’re innovating and bringing value to health organizations, and we already exist in the same space, we want to work with you — even if it means taking a smaller share of revenue.”

See the whole board

Unfortunately, we’ve seen again and again how otherwise desirable innovations can end up compromising ethics, outcomes, and equity: Racial and other biases that creep into our AI algorithms; clinical trials that fail to represent the diversity of populations that should benefit from discoveries; EHRs and other tools that promise efficiency but instead lead to provider burnout.

A responsible approach to innovation requires us to do better by seeing the whole board and gaming out downstream impacts. For responsible investors, Taneja says, this means asking the hard questions of portfolio companies up-front. “Every time you make a business model decision, or if you’re relying on AI to make important decisions in your business, it’s incumbent upon us as the fiduciaries to ask the questions around what perhaps might be the unintended consequences of those choices.”

At RUSH Health, whose health equity efforts were recently singled out by TIME magazine as a “blueprint for other hospitals,” Lateef has learned that a key way to see the whole board is to ensure you have the right lens. That means designing inclusive partnerships that bring a diversity of mindsets and lived experience to the table. “Whether it’s a potential technology partner or someone who’s going to fix our parking garage, we want to know who they are and what neighborhood they’re from. As an anchor network in Chicago, diversity and inclusion is core to our mission.”

Harrison argues that healthcare technology and innovation must aspire to do more than just avoid complicity; it should actively surface and eliminate biases or disparities that would otherwise remain hidden. At Intermountain, one data project designed with this intent showed that Spanish-speaking stroke patients had to wait longer for clot-busting treatment than English speakers. “When our emergency doctors and our stroke neurologists saw this, they were appalled. Using technology to identify these issues and make them transparent allows you to address them with targeted solutions. That is precisely why I’ve joined General Catalyst — to work in partnership with healthcare and tech leaders to seek to develop the solutions that ultimately allow us to deliver better care for all people.”

If there’s any upside at all to the current down market, it may be this: It’s as good a moment as any to collectively pause, take a step back, and recalibrate. A time to talk less about transformation as a buzzword and more about what we want healthcare to transform into — and how we realistically get there from here. It’s an opportunity to humbly seek allies from every corner of healthcare, turn competitors into collaborators, and make room for odd bedfellows — what Lateef pragmatically sums up as “a group of the willing.” Now is the time to gather forces to focus not on short-term wins and gains but on creating enduring long-term value for all.

Ashwini Zenooz, MD is a physician and the chief executive officer of Commure.

John Fox, PhD is the co-founder and co-principal of Slipstream, reporting on the biggest health issues of our times.

 

 

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The New Pangenome Project Just Unlocked the Future of Precision Medicine

With a more inclusive reference data set, scientists and doctors will be able to more easily spot clinically relevant genetic variants for all people.

A new genomic resource released by scientists this month promises to streamline the use of genomic testing and precision medicine for patients of all ancestries. It is a significant advance that comes two decades after the first human genome sequence was declared complete.

The original human genome sequence was based largely on the DNA of a single person, with bits and pieces of DNA from other individuals added over time as scientists learned more about our genomic blueprints. This genome sequence served as a reference for the entire genomics community; any DNA sequenced from another person was immediately compared to the reference to glean important insights about disease risk and other traits.

But all along, researchers knew that having a single reference genome would limit what they could learn about other people — especially people whose ancestry isn’t represented by that genome. The genome-based tests used to guide precision medicine, for example, often can’t find genetic variants that have not been previously identified in the reference genome. Genetic variants that are common in other populations might be clinically meaningful, but are likely to go undetected without a more representative reference.

Now, scientists have published what they call a “pangenome” reference. It’s a collection of high-quality genome sequences from 47 people of diverse ancestries from Africa, Asia, and North and South America. The work comes from the Human Pangenome Reference Consortium, a large collaboration of scientists funded to the tune of $40 million by the National Human Genome Research Institute (NHGRI). It’s the first phase of a larger project that aims to sequence 350 people by 2024 to capture a broad range of human genetic diversity.

Pangenome Tube Map – like a map of the subway system, the pangenome graph has many possible routes for a sequence to take, represented by the different colors. (Learn More: www.genome.gov/pangenome) Credit: Darryl Leja, NHGRI

One of the most important outcomes of this new resource should be to improve genome interpretation — the task of spotting clinically relevant genetic variants to diagnose or prevent disease or to match a patient to the right treatment. “Everyone has a unique genome, so using a single reference genome sequence for every person can lead to inequities in genomic analyses,” said Adam Phillippy, a consortium member and scientist at NHGRI, in a statement announcing the pangenome. Scientists and doctors will have a better chance of finding key genetic variants when they compare someone’s DNA data to this large reference set of genomes than they did when the reference was just one genome.

“This will help make the reference useful for all people, thereby helping to reduce the chances of propagating health disparities,” said Eric Green, NHGRI director, in the same statement.

The pangenome could also provide a much-needed foundation for new initiatives to automate the genome interpretation process or even to incorporate AI into interpretation. Until now, efforts to streamline the discovery of genetic variants and other key steps needed to interpret a genome have been constrained by the limited utility of a single reference genome. With nearly four dozen genomes — and by this time next year, potentially hundreds of genomes — it should be much easier to deploy advanced computational tools and improve what is now a largely manual process.

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AI Dangers: Real or Human Hallucination?

The backlash to advances in artificial intelligence have come in all shapes and forms, from mild concern to dramatic over-reactions. Here’s a look at the primary concerns.

When we read history books, decades from now, November 30th of 2022 will mark a turning point. That was the day Open AI unleashed ChatGPT on an unsuspecting public. Five days later ChatGPT had 1 million users. And just like that, we entered the biggest and possibly most consequential beta test of humanity.

Reports of hallucinating, obstreperous chatbots and talk of stochastic parrots set off a media frenzy. Five months into the experiment and we have hundreds of competing AI chatbots vying to do everything from rule on legal matters, diagnose our medical conditions, invest our money, hire us for our jobs, and yes, write this column.

Like stages of grief, we are cycling through the stages of public experimentation with AI. Very publicly.

Stage 1: Marvel. “Isn’t this amazing”?

Stage 2: Mastery We can break this because we’re smarter.

Stage 3: Rational terror. “Gee, this is getting scary. They’re learning faster than I am and I have no idea where they’re learning what they know.”

Stage 4: Backlash. We’ve got to put some guardrails around this thing before it does serious damage.

The Backlash Scenarios

Backlashes come in all shapes and forms, from mild concern to dramatic over-reactions. But, it’s useful to look at the broad range of reactions we’re seeing to the birth of publicly available AI. Here’s a look at the primary concerns.

Information Will No Longer Be Free

Large language models like ChatGPT are trained on as much of the Internet as they can gobble up. Vast repositories of human information housed on places like Reddit, Twitter, Quora, Wikipedia as well as books, academic papers and crazy chats are scraped as training grounds for these models. In the past many platforms have made their Application Programming Interface (API), the method through which outside entities can incorporate program’s information, freely available.

Suddenly, freely available means “no cost” trainers for companies like Open AI. Should companies whose businesses rely on its body of knowledge be giving this away freely?  Doubtful “free” will continue as companies demand compensation for data feeding the AI beast,

The NYT recently reported that Reddit wants to begin charging companies for access its API. Twitter is also cracking down on the use of its API, which thousands of companies and independent developers use to track the millions of conversations. Microsoft announced a plan to offer large businesses private servers for a fee. That way they could keep sensitive data from being used to train ChatGPT’s language model and could also prevent inadvertent data leaks.

Then there are businesses that will begin to opt out or silo their data and communications, fearful of being part of ChatGPT’s unquenchable thirst. Companies including Samsung banned the use of generative AI tools like ChatGPT on its internal networks and company-owned devices. Financial companies including JP Morgan, Bank of America, Citigroup, Goldman Sachs, Wells Fargo and Deutsche Bank have either banned or restricted the use of AI tools.

The implications for both scenarios are vast. Large platforms have, in the past made their APIs available to the public for research, 3rd party development, and more. If they begin asking for compensation, all bets are off. The entire ecosystem of 3rd-party development could be upended. So could the entire nature of an open-Internet.

The natural extension of opting out is that every news outlet, blogger, and other contributors to the web starts either asking for compensation based on their contribution or silos its information. Information would be held hostage.

Great Minds Call for a Moratorium

Dr. Geoffrey Hinton, a Google researcher often called “The Godfather of AI,” very publicly announced he would leave Google so that he could speak more freely about the risks associated with using AI.

Before Hinton’s departure, came that well publicized “bro” letter where industry insiders including Steve Wozniak, Elon Musk, and other typically impetuous thinkers, wrote a public letter to Open AI asking the founders to pause further training on its learning model until it was better understood. That’s probably not going to happen. ChatGPT already opened pandora’s box, let the genie out of the bottle.

Regulation

Italy banned ChatGPT. So did China, Cuba, and a host of other countries. Regulators and legislators worldwide are scurrying. The EU has been leading the way for some time. In 2020, a European Commission white paper “On Artificial Intelligence—A European Approach to Excellence and Trust” and its subsequent 2021 proposal for an AI legal framework looks at risks posed by using AI. Following suit, the White House put forth its own blueprint for an AI Bill of Rights. It is not codified into any law, but rather a framework created by the White House Office of Science and Technology Policy to protect the American public in the age of artificial intelligence. This week the White House took its next move by announcing a series of steps to fund AI research institutes, systematically assess generative AI systems, and meet with the CEOs of large AI platforms in order to inform policy.

Chamath Palihapitya, the founder and CEO of Social Capital, a large venture fund, argues that  “given the emergence of so many different AI players and platforms, we need a public gatekeeper. With an effective regulatory framework, enforced by a new federal oversight body, we would be able to investigate new AI models, stress-test them for worst-case scenarios, and determine whether they are safe for use in the wild.”

Regulators are still debating what to do about everything from existing social media platforms to cryptocurrency. They are unlikely candidates to move swiftly on the AI issue.

You Can’t Regulate What You Can’t Understand

Looking elsewhere, one of the most clear-headed analysis comes from Tim O’Reilly, author and publisher of O’Reilly media. Like Palihapitya, O’Reilly penned an open letter calling for increased AI transparency and oversight, but not necessarily governmental. The first step, says O’Reilly is “robust institutions for auditing and reporting.” As a starter he asks for detailed disclosure by AI creators in some form of public ledger.

There’s also a sweet irony in all these scenarios. Technology cheerleaders who have always been leery of regulation are now begging for some regulatory body to step up to the plate. Cynics might call this enlightened self-interest, but I suspect it’s because they truly understand the magnitude of this technology.

There’s a long-standing precedent of oversight by committees when new technologies hit the market. A recent example is the Metaverse Standards Forum, which I’ve written about before, where important issues from interoperability to privacy are tackled by committee. In the world of biology and genetics, CRISPR technology is also wending its way towards a regulatory framework.

The definition of a backlash is “a strong, adverse reaction to a controversial issue.” Economic models of compensation will be worked out. An outright ban is a folly. A moratorium seems unlikely. Regulators will forever be behind the eight-ball. That leaves us with oversight, transparency, and a public ledger as the best defense. The backlash to AI is not a human hallucination. It’s real, and deservedly so.

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Deep-Sea Mining’s Dirty Dilemma

Mining promises to kick up a bunch of seafloor-smothering sediment. The question is: how much?

Industrial mining in the deep ocean is on the horizon. Despite several countries including Germany, France, Chile, and Canada calling for a pause on the field’s development, the International Seabed Authority (ISA), the organization tasked with both regulating and permitting deep-sea mining efforts, is nearing the deadline to finalize rules for how companies will operate. Companies, meanwhile, are busy testing the capabilities of their machines—equipment designed to collect polymetallic nodules, rocks rich in cobalt, nickel, copper, and manganese that litter some parts of the seafloor.

Top of mind for many scientists and politicians is what ramifications deep-sea mining might have on fragile marine ecosystems, including those far from the mining site. At the heart of the debate is concern about the clouds of sediment that can be kicked up by mining equipment.

“Imagine a car driving on a dusty road, and the plume of dust that balloons behind the car,” says Henko de Stigter, a marine geologist at the Royal Netherlands Institute for Sea Research. “This is how sediment plumes will form in the seabed.”

Scientists estimate that each full-scale deep-sea mining operation could produce up to 500 million cubic meters of discharge over a 30-year period. That’s roughly 1,000 six-meter-long shipping containers full of sediment being discharged into the deep every day, spawning from a field of mining sites spread out over an area roughly the size of Spain, Portugal, France, Belgium, and Germany.

These sediment plumes threaten to smother life on the ocean floor and choke midwater ecosystems, sending ripples throughout marine ecosystems affecting everything from deep-sea filter-feeders to commercially important species like tuna. Yet discussions of the plumes’ potential consequences are clouded by a great deal of uncertainty over how far they will spread and how they will affect marine life.

To clarify just how murky deep-sea mining will make the water, scientists have been tagging along as companies conduct tests.

Two years ago, Global Sea Mineral Resources, a Belgian company, conducted the first trials of its nodule-collecting vehicles. Scientists working with the company found that more than 90 percent of the sediment plume settled out on the seafloor, while the rest lingered within two meters of the seabed near the mined area. Other studies from experiments in the central Pacific Ocean found that the sediment plumes reached as far as 300 meters away from the disturbed site, though the thickest deposition was within 100 meters. This is a shorter spread than earlier models, which predicted deep-sea mining plumes could spread up to five kilometers from the mining site.

Beyond the sediment kicked up by submersibles moving along the seafloor, deep-sea mining can muddy the water in another way.

As polymetallic nodules are lifted to the surface, the waste water that’s sucked up along with the nodules is discharged back into the ocean. Doug McCauley, a marine scientist at the University of California, Santa Barbara, says this could potentially create “underwater dust storms” in upper layers of the water column. Over the course of a 20-year mining operation, this sediment could be carried by ocean currents up to 1,000 kilometers before sinking to the seabed.

Some particularly fine-grained particles could remain suspended in the water column, traveling long distances with the potential to affect a wide range of marine animals. According to another recent study, it’s these tiny particles that are the most harmful to filter-feeders like the Mediterranean mussel.

To avoid these consequences on midwater ecosystems, at least, scientists are advising would-be deep-sea miners to discharge waste water at the bottom of the ocean where mining has already created a disturbance. This would be a departure from the ISA’s messaging, which is to not specify at what depth waste water should be released.

For its own trials last December, the Metals Company (TMC), a Canadian company, says it worked hard to minimize the amount of sediment discharged in the waste water it released at a depth of 1,200 meters.

“We’ve optimized our system to leave as much sediment on the seabed as possible,” says Michael Clarke, environmental manager at TMC. Clarke says he’s skeptical of previously published research projecting vast sediment plumes. “When we were trying to measure the [midwater] plume a few hundred meters away from the outlet, we couldn’t even find the plume because it diluted so much.”

Clarke says the company is currently analyzing both baseline and impact data for its test mining, including looking at how far small particles spread and how long they remain suspended. The results will be submitted to the ISA as part of an environmental impact assessment.

As deep-sea mining inches closer and scientists ramp up their research efforts, it’s important to keep one thing clear: “I can tell you that we’re not going to discover that deep-sea mining is good for marine ecosystems,” McCauley says. “The question is, How bad will it be?”

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Carbon Removal Tech Would Use More Energy than All Homes Combined, Shell Finds

It would take more energy than all the world’s houses will consume in 2100 to power a fledgling technology that captures enough carbon dioxide from the air to limit global heating at 1.5°C, according to British multinational oil company Shell.

It would take more energy than all the world’s houses will consume in 2100 to power a fledgling technology that captures enough carbon dioxide from the air to limit global heating at 1.5°C, according to British multinational oil company Shell.

In a Shell scenario where the world limits global warming in line with the Paris climate agreement, energy demand for direct air capture (DAC) technology rises “from about nothing today to almost 66 exajoules in 2100,” reports Bloomberg.

“That would be more than the energy needed to heat and power all the world’s homes by then,” the news agency adds. [It isn’t clear how much energy efficiency or fuel switching is built into that comparison, but 66 exajoules is still a huge amount of energy—Ed.]

Bloomberg cites Sky 2050, the more optimistic of Shell’s two latest energy security scenarios [pdf], in which long-term climate security is the priority embraced by all. In this pathway, DAC with carbon storage (DACCS) deployment is in full swing by 2040, absorbing more than five billion tonnes of carbon dioxide per year. The united efforts of politicians, the public, and the private sector achieve net-zero by 2050, and although 1.5°C is breached sometime mid-century, collective action brings temperatures back down to 1.24°C by the century’s end.

In Shell’s bleaker Archipelagos pathway, energy security fears trump climate concerns, with no apparent reference to the potential of less expensive solar and wind to meet both objectives. Efforts at collective action fall by the wayside, and DACCS is virtually abandoned until 2080. “The global average surface temperature is still rising in 2100 but is leveling off at around 2.2°C as emissions close in on net zero,” Shell projects.

That’s after years of hearing that 1.5°C is the guardrail for averting the worst effects of climate change, and that every 0.1° between 1.5 and 2.0°C will be measured in lives saved or lost.

These models come nearly four years after researchers at Imperial College London’s Grantham Institute for Climate Change wrote in a Nature Communications study that in 2100, DAC machines could needed 300 exajoules of energy annually, or 25% of total global energy demand.

“To put it another way, it would be equivalent to the current annual energy demand of China, the United States, the European Union, and Japan combined,” Carbon Brief wrote at the time.

According to the Grantham Institute researchers, DAC—still at an experimental stage but generally involving an energy-intensive process where the greenhouse gas is “captured” using chemical “sorbents”—could “allow a reduction in near-term mitigation effort in some energy-intensive sectors that are difficult to decarbonize, such as transport and industry.”

Work by the Intergovernmental Panel on Climate Change (IPCC) maintained that negative emissions technologies like DAC willbe required to keep global heating below 1.5°C, but warned that such technologies must never be deployed as an alternative to emissions reductions. The IPCC’s Summary for Policymakers issued last month made no mention of DAC as a realistic element of a decarbonization plan; it identified solar, wind, and methane capture from the fossil industry as the quickest, most cost-effective ways to drive down emissions.

At the time of their study, the Grantham researchers did conclude that DACCS “reduces the marginal abatement costs to achieve the climate target by between 60 to more than 90%.” But there remained uncertainty about whether it is possible to scale DAC technology fast enough to capture the necessary target of 30 gigatonnes of carbon dioxide per year. A 2019 study found that this would require building 30,000 large-scale DAC factories. “For comparison, there are fewer than 10,000 coal-fired power stations in the world today,” Carbon Brief said.

“The risk of assuming that DACCS can be deployed at scale, and finding it to be subsequently unavailable, leads to a global temperature overshoot of up to 0.8°C,” the study authors warned.

Shell’s scenarios do not address the problems of scaling DACCS, nor the danger of overshoot.

And such dangers should not be discounted, Carbon Brief deputy editor and climate and energy policy editor Dr. Simon Evans told The Energy Mix in an email: “The evidence suggests it would be risky to assume we will be able to deploy lots of direct capture at low cost.”

That risk could be minimized by cutting emissions more quickly and reducing the need for carbon removals, Evans added. “For example, by tackling energy demand as well as supply.”

Despite the unknowns, there’s major interest in DAC, Bloomberg reports, with governments as well as the private sector heavily invested in its success. The Biden administration has a new US$3.5-billion DAC program, and fossil mammoth Occidental Petroleum is planning a 2024 launch of the world’s first million-tonne DAC plant, known as DAC1, in the Permian Basin, the massive U.S. fracking fields in Texas and New Mexico.

1PointFive, the Occidental subsidiary developing DAC1, has pledged that all its DAC plants “will be powered by zero-emission energy sources, such as wind, solar, or NET power.”

According to Net Power (another Occidental subsidiary), “NET power” is produced by burning natural gas in the presence of oxygen, then using the resultant carbon dioxide in a “turbo-expander” to produce electricity. It is then either pressurized for export or recirculated. Located as it is in the Permian Basin, DAC1 will have plenty of natural gas close at hand.

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Inside the United Nations’ Water Week

Over 2 billion people lack access to safe drinking water, and around 4.2 billion people–more than half of the world’s population–experience severe water scarcity for at least one month per year. 

The climate change discussion takes center stage, but water plays the most important supporting role. Water scarcity and quality are intimately connected to climate change with droughts and flooding increasing in severity each year.

At the end of March, NYC ushered in UN Water Week to put the focus squarely on the role of water as a human right.  The statistics are sobering. Almost half of the world’s population is affected by water scarcity. According to the United Nations, over 2 billion people lack access to safe drinking water, and around 4.2 billion people–more than half of the world’s population–experience severe water scarcity for at least one month per year.  Ninety percent of natural disasters are water related.

On a recent visit to the UN in Geneva I was reminded by my host that nearly one-third of the world’s population relies on surface water for drinking. A young woman from Turkmenistan shared that her country’s major source of water, the Aral Sea, has largely turned to salt ­– a problem so overwhelming that when the wind blows it often feels like it’s raining salt.  Rivers are also affected.  Changes in temperatures and salinity are leading to a severe decline in biodiversity.

About 1.2 billion people worldwide drink surface water that is untreated and potentially unsafe, leaving them at risk of contracting diseases such as cholera, typhoid, and diarrhea. Untreated sewage, industrial waste, and agricultural runoff are among the leading contributors to surface water pollution. The toxicity of groundwater is caused in part by the plastic waste in these waters. It is estimated that there are 5.25 trillion pieces of plastic in the ocean. These plastics harm marine life and are also ingested by humans, especially children, and nearly impossible to remove from the body. Microplastics are ubiquitous, having been found in human fetuses and freshly fallen snow in Antarctica.

At UN Water Week young water-workers seeking to bring about change in their respective countries were invited to speak. A young gentleman from Kenya reported that 90% of kids in his country consume microplastics in water.

The GeoPolitics of Water

While lots of the earth is covered in water (71%), just over 2.5% is covered by fresh water. Hence, water often becomes the root of geographic disputes. Throughout the Water Week conference there was talk of struggles to conquer, but also to cripple, water supplies by attacking hydro-electric dams.

There is also a schism between developed and less developed countries. Wealthier countries experience water issues primarily in terms of property (mostly flooding) while  poorer nations suffer in terms of people (mostly water borne disease).

An encouraging thought?  110,000 young people from 68 countries took part in the Water Week’s initiatives worldwide. Jobs in water management were touted as career paths for young ambassadors. The spokeswoman from the Dominican Republic spoke eloquently on the need for low tech solutions like composting toilets, asking the audience to not always rely on the silver bullet of high tech to solve all water problems. The Nigerian delegate also brought up the need for dry toilets to increase overall sanitation.

As part of the Water Week the Netherlands teamed up with NYC to create a special program focused on solutions like reducing pollution, ecological construction of dams, improving protection from flood though the building of dykes and levees, waterproofing buildings, integrating nature based solutions, and reducing pollution and runoff especially in agricultural areas.  The Dutch, no strangers to water management living in a country where seawater is a constant threat, have taken a leadership position.

More Crop Per Drop

Seventy two percent of all water withdrawal is currently used by agriculture, as opposed to 16% used by municipalities and households. Agricultural advancements in water usage involve more sparing use of water, rainwater management, and the use of non-potable grey water for crops. Technologies like IoT sensors in the field that measure and control the exact amount of water required for a given crop are already widely used.

Household Use

Where education and new technologies are most sorely needed are in homes and municipalities. Simple, low tech aerators are being installed to control the flow of water through bathroom and kitchen faucets by mixing air with the water. This can often reduce water flows by 30% without sacrificing performance.

Leak detection systems are also being used more frequently, as are shower regulators (yes, pleasurable as they are low pressure showers that can save lots of water).  A water flow restrictor or a low-flow shower head reduce a flow of between 5-8 gallons per minute to 2.5 or fewer gallons per minute.  Two leading water leak detection products are the Phyn Plus Smart Water Assistant + Shutoff and the Flo Smart Water Monitor and Shutoff. Low tech solutions including saving the cold water from your tap while you wait for your water to heat up can save as water as well.

On-demand, or tankless, hot water heaters have become increasingly popular. These tanks don’t heat hot water and store it in an insulated tank. Instead, it senses when a hot water fixture is opened, such as turning on a shower, or starting a washing machine to clean a load of clothes, and only then starts heating water. The hot water heater heats the water as it flows to where it is needed in a home. And for goodness sake, train yourself to shut the tap while you’re brushing your teeth or soaping your face.

Building codes can also play an important part. In Flanders (the Northern part of Belgium) water scarcity became an issue nearly 20 years ago. In 2004 the collection and circulation of rainwater for non-potable use was mandated as part of the building code.

At Water Week I also got to see some emerging technology like  Hydraloop, a residential product designed in the Netherlands that separates out grey water from laundry, showers, and dishwashing from dirty water. It then reconditions the grey water through a system that allows it to be used for these same functions. Separating potable from non-potable water and reusing the non-potable could ultimately garner adoption, especially as the price of systems like Hydroloop’s come down.

Conserving water is going to require a combination of high tech, low tech, and a good wallop of common sense. But it starts with using potable water for drinking and other forms of water for everything else. It won’t reverse climate change but it’s absolutely critical in protecting us from its affects.

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Experts Convene to Address Ethical Concerns of Artificial Intelligence

Techonomy and Wipro Host Ethics and AI Discussion at SXSW 2023

Techonomy hosted the dinner in partnership with Wipro and attendees included executives, thought leaders, researchers, and policymakers. Several attendees also gave talks on AI at the conference, and the topics discussed included the gendering of AI, jobs lost to automation, and how to manage AI’s rapid growth. 

One of the critical topics of discussion was algorithmic bias. One attendee said, “AI systems are only as unbiased as the data they are trained on. If the data is biased, the resulting AI system will be as well.” Other attendees questioned whether creating an unbiased data set was even possible. Nevertheless, increasing diversity in the data used for training and developing more transparent and explainable algorithms was cited as a top priority for all AI development.

When the topic turned to potential job losses due to AI-based automation, no one at the table knew anyone replaced by an AI. A guest who manages a small, ten-person call center said they were looking at AI-based solutions that could result in job losses. When asked, they replied: “right now.”

The conversation at the dinner generally revolved around the ethical considerations that arise from the development and use of artificial intelligence systems. Attendees emphasized the importance of responsible AI development that benefits society while minimizing potential harm.

The conversation also touched on the topic of data privacy. As one attendee noted, “AI systems often require large amounts of data to be effective, but this data can be sensitive and personal.” Attendees debated how to balance the benefits of AI with the need to protect individual privacy, with some suggesting stronger data protection laws and privacy-preserving technologies.

The ethical implications of automation and autonomous systems were also discussed. 

Accountability was another topic of discussion, with attendees emphasizing the need to hold those responsible for developing and using AI accountable for any harm that may result. One attendee stated, “As AI becomes more widespread, it is important to ensure that those responsible are held accountable for any negative consequences.” Attendees debated establishing accountability frameworks that encourage responsible behavior and discourage unethical or harmful actions.

Finally, attendees discussed the need for increased transparency in AI. One attendee said, “It can be difficult for individuals to understand how AI works and why it makes certain decisions, which can be a barrier to trust and acceptance.” Attendees considered ways to increase transparency in AI, such as through explainable AI techniques, user-friendly interfaces, and open-source development.

Overall, the conversation at the SXSW dinner sponsored by Techonomy and Wipro highlighted the importance of responsible AI development and the need for ongoing dialogue and collaboration between stakeholders to ensure that AI is developed and used ethically and responsibly.

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