Fossil Fuels Divestment & Medical Professionals: How AMA’s New Policy Can Work for You Todd L Sack MD FACP Jacksonville, Florida tsack8@gmail.com 904-403-6446 August, 2018

Todd L Sack, MD, FACP tsack8@gmail.com 904-403-6446 Fossil Fuels Divestment & Medical Professionals Todd L Sack, MD, FACP tsack8@gmail.com 904-403-6446 ~ I have no financial interests or disclosures ~ Weather and climate change play a significant role in our health and well-being. I’m going to discuss some health issues related to waterborne infectious disease. There are an estimated 12-19 million outbreaks of endemic waterborne disease annually in the US., with many of the infectious agents not identified….so probably a much bigger problem.

“Do your little bit of good where you are; it’s those little bits of good put together that overwhelm the world.” Rev. Desmond Tutu

Divestment & Health Professionals Why divest? Clara Vondrich, www.divestinvest.org Fossil fuels are simply bad investments Investment diversification does not require fossil fuels The fossil fuels industry’s disinformation campaign Opportunities of renewable energy & energy efficiency Climate change & human health AMA’s experience and your organizations After your divestment decision Resources

Climate change is the #1 public health threat of the 21st Century.

Climate Change and Human Health Catastrophic storms Extreme heat events Air pollution Flooding, drought, fires Population displacements Vector-borne diseases Malnutrition & famine Political instability

Air pollution: Our Most Vulnerable Patients Neonatal brain development Childhood asthma Allergies (pollens, smoke, particulates, toxins) Heart disease COPD Mental health & well-being Malignancies

AMA’s Divestment Policy Timetable (https://www. ama-assn 1989: Stewardship of the environment 1990: Spokespersons for environmental stewardship 1996: Divestment of tobacco company holdings 2001: Social contract with humanity 2008: Global climate change & human health 2010: Greenhouse gas regulation by U.S. EPA 2016: Advocacy on environmental sustainability & climate change 2017: Fossil fuels divestment: referred for study 2018: Fossil fuels divestment: adopted

A Family of Policies for Your Organization An environmentally-sustainable organization Wise vendor selection Teaching members environmentally sustainability Educating on climate change and health Emphasis upon vulnerable communities Fossil fuels divestment

“AMA to Protect Human Health From the Effects of Climate Change by Ending Its Investments in Fossil Fuel Companies” Submitted by AAPHP. Adopted June, 2018 commitment to divest “in a timely, incremental, fiscally responsible manner, to the extent allowed by their legal and fiduciary duties” choose vendors with “environmental sustainability practices” create policy analyses & CME programs, support physicians, teach legislators, assist physicians & other health organizations with divestment decisions

“AMA to Protect Human Health From the Effects of Climate Change by Ending Its Investments in Fossil Fuel Companies” 1. The American Medical Association, AMA Foundation, and any affiliated corporations will work in a timely, incremental, and fiscally responsible manner, to the extent allowed by their legal and fiduciary duties, to end all financial investments or relationships (divestment) with companies that generate the majority of their income from the exploration for, production of, transportation of, or sale of fossil fuels; and 2. The AMA will choose for its commercial relationships, when fiscally responsible, vendors, suppliers, and corporations that have demonstrated environmental sustainability practices that seek to minimize their fossil fuels consumption; and 3. The AMA will support efforts of physicians and other health professional associations to proceed with divestment, including to create policy analyses, support continuing medical education, and to inform our patients, the public, legislators, and government policy makers. Adopted June, 2018

After Your Divestment Decision What values are important to your organization? coal only? all fossil fuels? renewables? ESG? Who will give instructions to your fund managers? Who will monitor your fund managers? Who will report back to the membership? How will you assist your members?

Divestment Resources Your fund managers and financial planners Divestinvest.org Fossilfreefunds.org Gofossilfree.org/top-200/ Sriwelthmanagement.com (Thomas.Vandyck@rbc.com) Ethoetf.com/fund/ Many others

Todd L Sack MD FACP tsack8@gmail.com 904-403-6446 Fossil Fuels Divestment & Medical Professionals: How AMA’s New Policy Can Work for You: “Thank you!” Todd L Sack MD FACP tsack8@gmail.com 904-403-6446

Fiduciary Arguments: Bad Investments (bad for your organization AND your members) Fossil fuels are the worst performing sector for the past one-, five-, & ten-year periods Coal Index value is down 60% since 2008 France, Netherlands, Norway, & China have time-tables for banning fossil-fuel vehicles Many fossil fuel reserves will remain in the earth as “stranded assets” Better investments are in renewable energy & energy efficiency

Fiduciary Arguments: Portfolio Diversification Modern Portfolio Theory emphasizes diversification to lower risk Fossil fuel stocks & bonds comprise just 6-9% of US markets Removing any single sector of this size has a negligible impact Removing fossil fuels should increase long term returns