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Sea | 2021 The Future 50 | Fortune

Chris Morris

The sand is so hot in Florida that nearly all sea turtles born there are now female

/2022/08/08/florida-sea-turtles-female-hot-sand/

His research will help humans prepare for life on Mars.

A professor is spending 100 days underwater— and footing part of the project’s $120,000 bill

Tech

And footing part of the project’s $120,000 bill.

Why this man is spending 100 days underwater

Well, there's one person that's staying under water for 100 days. That's me. So everybody keeps saying we're going to Mars, we're going to Mars, we're going to Mars. And you know, I keep thinking Elon, you may have a couple of things we have to work out between now and then. My name is Joseph De Tori and I'm a clinical researcher. I have a phd in biomedical engineering and I'm a 28 year veteran in the United States Navy. We're exposing myself to 100 days in this isolated confined extreme environment wherein I'm doing physiologic tests on myself. So, so that when we get ready to go to Mars, we've already worked out some of this stuff, including blood urine, saliva continually throughout doing EKG S pulmonary function tests, blood pressure tests. It's a simple analogy. I'm basically in this tin can that is, is going through space and time. Every once in a while I got to get out and go clean the porthole. That's exactly the kind of stuff you have to do. There's all kinds of similarities to it and like I said, we can work out a lot of problems here before we go anywhere else. So we just want to know what happens to the human when you're just kind of leave it alone in a tube for, you know, a long period of time.

Ethan Brown, Founder, President and CEO, Beyond Meat
Josh Hix, Chief Executive Officer, Season Ashley Tyrner, Founder and CEO, FarmboxRx Moderator: Jennifer Fields, FORTUNE

Brainstorm Health 2023 - Food As Medicine: Eating Your Way To Good Health 

Conferences

Ethan Brown, Beyond Meat
Josh Hix, FarmboxRx 
Jennifer Fields, FORTUNE

Food As Medicine: Eating Your Way To Good Health 

Coming up another important topic. A few months ago, the White House held a long overdue event. The first conference on hunger, nutrition and health in more than 50 years, the focus was on ending hunger, increasing healthy eating and cutting diet related diseases like diabetes and obesity and high blood pressure. We've heard a lot about some of these topics throughout the course of the day. There's little doubt that eating rights can affect health outcomes pretty much every doctor we see now talks about the importance of eating well. But what does that mean? This notion of food as medicine is an increasingly important topic? And we are going to learn a bit more about it today. So let's drill down on this idea with three entrepreneurs and innovators who are working to revolutionize access to food as well as what we put on the dinner table. We've got Ethan Brown, the founder, president and CEO of Beyond Meat. We've got Josh Hicks, the CEO and founder of Season Health, where we are also an investor and uh Ashley Turner, who is the founder and CEO of Farm Box R X. They will be joined by Fortune Zone Jennifer Fields for a conversation on how we can all eat our way to better health. Please join me in welcoming them onto the stage. Thank you all so much. I'm gonna jump right in. Um Josh, I'm gonna throw out the first question to you. Food is medicine is a relatively new movement. What have you learned so far about its effectiveness at reducing chronic disease? Wow. I feel like this knowledge has been around for a very, very long time in various forms. People love to quote the food be medicine a bit. And I think in more recent decades, there's a lot of clinical evidence that food works to manage and reverse chronic disease. I think what's new in this space is the payment rails, the broader cultural awareness of these issues and probably, sadly the prevalence of the issues themselves, but there's no doubt that it works. And Ashley, you were recently quoted saying where you live down to your zip code can tell you better than anything what your health is going to be. Um I know you have first hand experience of living in a food desert, which is something that affects millions of people across the country who just don't have access to food. Can you tell us a little bit more about the connection between where you live and your health? Yeah. So really um talk about my back story. Um If we back up 13 years ago, I was a single mom, pregnant with my now 12 year old daughter living on food stamps in a rural food desert trying to live healthy on a food stamp budget is incredibly difficult enough. But living, you know, in a rural area, not having transportation is even more difficult. It's really where this idea came from. And something I'm very excited about outside of food is medicine is really population health data building because yes, down to our zip code can really determine what our health outcomes are going to be. And Ethan, I want to turn to you because beyond Meat has been the subject of some studies, Stanford did a study on the benefit of plant based meat. Um You're also doing some partnerships with the American Cancer Society. Um When we're thinking about food as medicine, plant based diets, obviously, um factor into that. Can you tell us a little bit more about the shift away from meat? Sure. So I think it's, you know, very clear to the to to the medical community that there's a very high correlation between the Western diet and the role that animal protein consumption plays and whether it's heart disease, diabetes or cancer or all these disease epidemics that we're facing and that are particularly prevalent within underserved communities. Um And so what we're trying to do it beyond meat is to rebuild meat directly from plants. So we take all the core parts of meat, the amino acid lipids, trace minerals, vitamins and water, but construct them in a way that's going to serve human health and also serve the environment. And by doing that, we can take out the things in meat that are problematic. And so we feel that there's tremendous advances that can be made in human health by doing that. So we've teamed with Stanford. We have a five year program with Stanford. It's an unrestricted gift so they can do all the research they want, we can't control the outcome, but they've done some pretty amazing studies at the beginning and they're continuing to do it today. The first one was the swap meat study where they had participants consume animal protein twice a day for eight weeks. They needed a one week wash out here and they went to be beyond meat twice a day for an eight week period. Then went back to animal protein just during that eight week period. They saw a drop in LDL cholesterol, both clinically and statistically significant drop, which is the bad cholesterol. They also saw a drop in something called T M O which is a compound that forms in the gut, which is very closely associated with heart disease and certain cancers. And so this is just the tip of the iceberg. There is so much that can be accomplished by going toward a plant based diet. Now, the challenge is we need to make sure that people are educated about that and understand the benefits and there's a lot of noise out there that's being promulgated by people who are maybe in the incumbent industry. And we need to look past that and help people see the benefits of plant based meat and plant based eating. So when we think about um moving in this direction, um whether it's plant based uh food or just creating uh reducing our food deserts, the the issue really comes down to accessibility. How do we make this more accessible to the, to the entire country? Um It's clear that better diets can improve health outcomes. But how can companies make this food more available? Ashley? You wanna start? Yeah. So I think a big piece of that is around data um especially as we talk around, you know what this conference is about for health care, right? Because it's just been recent in 2020 that C MS changed regulation allowing food and produce to be offered as a benefit under S S BC I. So that's one big piece of what farm box R X is doing is giving this data back to C MS and C M M. Um To show how you can move the needle on other health health outcomes. Um So if we take what we're doing to help give accessibility, you have to remember that if people don't have accessibility as in a location, a store delivery service, that's one element. There's also the affordability. If they can't afford to buy the healthy food, you know, it doesn't matter if they have access. So really, you know, fueling this movement with data around how giving food to members that are on Medicare. Medicaid can move the needle of other health outcomes. We have proven to have out of 268 members that participated in our original white paper with Molina Healthcare of New Mexico. Um We were able to prove 100% rate of return of the health risk appraisal. Anybody in this audience that's in the health care world on the payer side knows that that's normally 30 or 40%. We move the needle by 22% of members in our program going to get their diabetic eye exam going and getting their mammogram by 10% more, we reduced by 9% unnecessary er, admits. Um because at the end of the month, if individuals run out of snapping E BT dollars, they're notorious for going and just entering the emergency room to just get a meal. And so when you talk about that accessibility piece, it's also around affordability and bringing it forward within health care. That data makes sense beyond just the clinical side, right? Because it's an immediate roi if you can prove that you can move the needle on other hetu or stars measures other than the ridiculously obvious that if you eat healthier, you're going to be healthier. And Josh, do you have thoughts you wanna add to that? Yeah. I would just add that on the affordability piece. I think this is this is where we're starting to see the payment models and a lot of the the broader consumer side of the world start to converge, which is exciting. So we facilitate both food benefits within plans, existing and new benefits that are put in place to drive clinical outcomes and dietician care, put those things together, partner with plans and drive R O I around a handful of disease states and have some early but nascent conversations around preventative care as well. And I think that's a, a sadly separate conversation from chronic disease management where there's hard dollar R O I today, but on the issue of affordability, uh I completely agree, I think accessibility has largely been solved. Uh Sometimes that seems a bit more controversial than it should be between the major grocery stores. There's 99% zip code delivery coverage in the United States. You add in various food delivery companies and there is nowhere in the lower 48 that you can't get fresh food delivered. It's affordability. That's the question and at least, and, and it's definitely a journey to get, you know, everyone covered. But starting at the high acuity end of the spectrum, there is a hard dollar sub six month provable R O I case to do this. And we're starting to see payers pay for it, which is great because it means that we can solve the sort of twin issues of accessibility and affordability and all of a sudden there, you know, one of the things we say behind closed doors to some of our payer partners is there really is no excuse for food deserts anymore. Like that should not be an excuse. Everyone can get food delivered. We can tailor the food to cultural and other preferences and we can make it affordable for people and like that exists right at this very moment and there's no reason to be talking about food deserts anymore. If you're doing it, it's, you know, probably for some other reason. So I'm thinking about um oh also I'm gonna ask questions or open it up to the audience to ask questions shortly. Uh So think about your questions and um someone will be around with a microphone. But Ethan, I want to ask you another question thinking about the benefits of the plant based diet. The American diet is so the opposite of the plant based diet. How do we get more Americans to embrace this idea? Right. So we look at our history as a company as going from being very successful within the early adopters, folks that are predisposed to, to try uh plant based meats and have a motivation to do so. Uh But then you kind of rise through that in this kind of classic literature of technology disruption, you hit a wall as you try to get across the chasm into the mainstream. And that's really where we are right now. And we view three levers as being necessary to get across to the mainstream. And the first is really to continue to communicate the taste and the deliciousness of our products. The second is to clarify this health issue. You know, it is unassailable that if you're going to have a piece of meat, you should consume plant based meat from a health perspective. So when I eat meat, I eat plant based meat. That's the way to think about this. Not think about it. In terms of, you know, I'm gonna have this over a kale salad. You should continue to have your salads, you continue to have your chickpeas. But when you consume meat, the better health choice is plant based meat and we need to communicate that to everybody and make sure they understand that last and the most important one is price. We are economic animals as we, as we continue to scale our business and we continue to scale the supply chain. We're able to get direct materials down in costs. We're able to benefit from overhead absorption through greater scale. We will be able to underprice animal protein. And then you will see dramatic adoption throughout the United States to answer the question of accessibility, we will become accessible throughout every community once we underprice protein and that will happen, I set a goal four years ago. Now to in five years, we able to underprice, at least in one category animal protein. And so we're going to do that. And once we're getting into that economic motivation, you'll see a much wider spread adoption of plant based meat. I wanna open it up to questions. If not, I'll keep such a great job that I know nobody has a question. There's one over here. Hello, my name's Alex and I'm with uh I had a question regarding how you communicate about processing that's included in plant based meats because we spend all our time as health care professionals telling our uh patients and population not to eat processed foods, but plant pays meat foods are highly processed. So how do you think about that? Now, thank you. Did you were you planted in the audience? Uh That's a great question. Um So first is to get clear on language. So a process is a series of steps toward a desired outcome. That's the dictionary definition process. So it's not a bad thing, right? It's something that you have to do, right? To create something, right? And so 98% or so of the of the meat that most consumers are having in the United States goes through a factory farm process, right? And so the comparison is not between the idyllic thing you see on the package, but it's on the actual process that occurs for the animal protein industry. Now, we are so proud of our process and I hate it when I say this, but I'm going to say it. Take a road trip to Missouri. Don't fly to the carbon. Take a road trip. When you get there, knock on the door of our facilities, you can come in and we'll give you a tour. You don't have to call in advance because we love our process. We're proud of it. It's a great process, but I asked you to do that at a meat facility. They won't let you in. So our process is this, take our steak, for example, the beans are grown mostly in the Midwest, some in Canada and it's a fava bean. What's great about fava beans? They're nitrogen fixing. So they're bringing nitrogen into the soil. So the farmer is actually making more money because he doesn't have to use fertilizer. So we get the fava beans and the supplier does this for us and they're milk. We separate through an air chamber, the proteins, the different particle size and a starch. No chemicals are used. Then that protein is given to us. We run it through heating, cooling and pressure. Have you ever had Cheerios? You probably have, you get pasta, you probably have. That's the machine we use. That's the process. We're basically taking protein in a plant that looks like this and we're breaking the bonds and resetting them like this, which is the structure of meat and that's heating, cooling and pressure. That's it. You separate the protein from the starch, you run it through heating and cooling and pressure to reset the protein and we mix it some flavor. Take our steak product, for example, 21 g of protein. 62% less saturated fat, terrific product Time magazine on the cover, I think it is a delicious steak. A healthier steak. Turn it over. Look at the ingredients. Water vito weekly beans, press canola oil. Very simple, salt and natural flavors. Then there's like 1% of like pomegranate, onion garlic. I think there's like juice coloring, things like that. That's it. There's nothing artificial, there's not a single chemical. So we have to separate marketing and propaganda from fact. And if you're in business of telling people what to eat, you should know the facts. This is not ultra processed food. It's a very simple process and a better process than industrial meat that's put on your plate. We have another question back here. Hi, Alicia with special Olympics. We know that what we eat is so related to uh our, our generations are the intergenerational effects of obesity are so well known. Um And we even talked about social justice today is related and you and this is um you all also have referenced this. I'm wondering in your work, how do you address uh Children and changing children's eating habits as the next generation and so forth. So for us, uh I'll start for us, we engage the parent or the foster parent through health literacy that goes out in every single box. Right. So, it doesn't matter if you don't, you don't have accessibility affordability. You've also got to have health literacy because maybe they don't know how to cook with what's coming to them. So, you know, we'll do programs where we engage the parent or foster parent to engage the child um in, in different things. Maybe it's cooking, um, maybe it's, you know, also educating them to, uh at the end of the day, we identify as a food as engagement company rather than just food as medicine. Uh because it doesn't matter if, if you don't engage somebody in what's coming to them and they don't know what to do with it, then you can send food all day meals all day. It doesn't matter. So you got to engage, I think the parent or the caregiver or the child. Yeah, I would, I would just add to that. I joke with my team. I built a consumer food business before this and learned a lot of things that I think are like, painfully obvious. Uh including if you ask the patient, whether that's the child, the parent, whoever to act to eat differently than the rest of the household, it, it falls apart. I mean, it lasts somewhere between zero meals and like maybe a week. Uh And so for us, it's largely about using software, which I think, you know, this is also relatively well covered but there's a very obvious use for filtering across the infinite amount of food content out there. I mean, the internet is sort of just like cats and food content and you can find recipes that work for people based on all the things that really matter upstream of their clinical condition, their culture, their budget, what their spouse likes, what the kids like, what they ate yesterday and last week. And you know, and also by the way, their clinical condition and filtering through all that is relatively straightforward, it's just time intensive. Anybody could sit down on a Sunday and build a meal plan, just hardly anybody does. So our approach is to do the obvious thing which is help the entire household, whomever is there, use the benefits. And most of these benefits are structured in a way that they can so that whoever the patient is, will actually follow the clinical guidance and get the outcome. And in some ways, you know, the child in these settings is often uh sort of brought along, you know, on the journey in a good way. But there's not a very direct peer driven model that I'm aware of to address the kids directly. We're out of time. I'm gonna have to stop this there. But thank you so much for, for joining us.

Alyssa Jaffee, Partner, 7wireVentures
Alexis McGill Johnson, President and CEO, Planned Parenthood Federation of America 
Dr. Sandra Milligan, Head, Research & Development, Organon 

Brainstorm Health 2023 - Disparities In Healthcare: How Gender Plays A Role 

Alyssa Jaffee, 7wireVentures
Alexis McGill Johnson, Planned Parenthood Federation of America 
Dr. Sandra Milligan, Organon 

Disparities In Healthcare: How Gender Plays A Role 

Chelsea Clinton, PhD, Vice Chair, Clinton Foundation; Vice Chair, Clinton Health Access Initiative
Moderator: Deena Shakir, General Partner, Lux Capital; Co-chair, Fortune Brainstorm Health

Brainstorm Health 2023 - Global Health: The Power Of Public–Private Partnerships 

Chelsea Clinton, PhD, Vice Chair, Clinton Foundation; Vice Chair, Clinton Health Access Initiative
Moderator: Deena Shakir, General Partner, Lux Capital

Global Health: The Power Of Public–Private Partnerships

Well, hello everyone. It's so nice to see all of you. We, we've already started the countdown clock. We've only got 14 minutes and I have so much, I want to talk to you about Chelsea. So we're going to go ahead and dive right in and because of the limited time, start thinking about the questions you have. I'm hopeful, we'll get to at least one, maybe two. And there is somebody going around with a microphone who will come to you and will call on you once I get to ask a few of mine. So without further ado Chelsea Clinton, I want to ask you about the Clinton Health Access initiative also known as over the last two decades, Chai has negotiated over 100 and 40 global deals to lower the price of health products by 50 to 90% which is absolutely phenomenal. Can you share a bit more about Chai's origins and its approach to creating these types of partnership models to reduce health care costs? Yeah. Thank you so much, Dina and I wanna thank uh fortune um for inviting me and particularly giving me the chance to talk about uh public, private partnerships. Uh I also want to thank everyone here um at the Ritz Del Rey for keeping me hydrated and caffeinated. Um And I do know that uh these events are always real team effort. So just thank you to everyone I've met and everyone that I haven't met uh for bringing us here together today. Um So the genesis of chai really was in the HIV AIDS equity crisis, you know, more than 20 years ago where people living in places, you know, like Los Angeles at the beginning of the 21st century, were able to access uh largely anti retroviral drugs that were turning aids into certain desinence into a chronic disease. And my father and Nelson Mandela decided to work together kind of in their post presidential lives to try to help ensure that more people in more places could access these life saving medicines in 2001, the average price per person per year of a R V s in the global South was just over $10,000. Fast forward to today. It's about $60.21 million of the 29 million people who access antiretrovirals every day. Um, adults and kids alike access those medicines through agreements that the Clinton Foundation helped negotiate. But, oh, gosh, thank you. This is great. I feel like you all should travel with me all the time. I get like audible woos and applause. Um And I'm really proud of that market shaping work of of shifting um the power of the market to change a high price, low volume dynamic into a high volume, low price one now has characterized so much of our work. And so we've applied that same approach to the pneumococcal vaccine, the rotavirus vaccine injectable, long lasting reversible contraceptives point of care, diagnostics. We're now spending a lot of time in hepatitis in trying to increase access to medical oxygen and and so much else that we so often, I think um maybe don't take for granted but are not cognitive of what we have access to here in the United States to try to ensure that anyone anywhere has access to life saving medicines and commodities. And the last thing I'll say is a new effort that we're a part of is the new initiative launched by the World Health Organization last week to try to catch kids up on their routine immunization in 2021 alone, more than 25 million kids under the age of one missed at least one routine immunization. And so we're working with W H O and the Gates Foundation and others uh to hopefully have the largest kind of childhood immunization effort ever over the next 18 months to catch as many kids up as possible. Um because no one should die of polio or measles or pneumonia, including in this country where we also need people to be vaccinating their kids. Absolutely. Such incredibly important and impactful work. And you know, the topic of our panel today is public private partnerships and it's particularly meaningful for me because 13 years ago, I happened to be working with your mother at the State Department when she created the Office of Public Private Partnerships. Uh, so much has happened in those 13 years, including a pandemic. And I'd love to hear a little bit more about what the role of public and private partnerships is today in the context of global health and health care more broadly. Oh, goodness. Well, I think we have to continue to build on kind of what we know works and certainly, um you know, it is so much of our market shaping work and we also try to support our partners who are doing um work uh in kind of innovative delivery models and thinking about the work that partners in health and others are doing in Liberia and Sierra Leone to try to increase health care, workforce capacity and with innovating training modules to train front line nurses to be able to provide basic psychiatry kind of screening and care that's not in our bally or area of expertise. But hopefully, as those models prove themselves or iterate to prove themselves, we can help and try to bring them to scale. I do think though, you know, when you ask about the role of public private partnerships kind of after the last few years, I think we spend so much time, understandably focused on the M R N A vaccines and technologies. I spend a lot of time thinking about um the really uh unfortunate to try to use a not too judgmental word, um kind of rise in not only kind of vaccine hesitancy and questioning, but outright kind of rejection of vaccines and of kind of science and the scientific kind of process and also too often on our scientists, our epidemiologists, our frontline health care workers. And so I do think we need to have a much more robust conversation and sense of urgency because I think we are less prepared today than we were arguably in January of 2020. Partly because of the kind of um lack of trust and confidence in uh in not only our scientists um but in, in science itself, um and certainly in the public health professionals. And so I think we need kind of the public sector to hopefully stop doing things like stripping away public health emergency powers from state public health agencies. But we also need the private sector to help candidly like do a better job of helping explain kind of the science that you are already commercializing and bringing to market, but also what you're working on and and help us kind of in the broader conversation, not be uncomfortable with the discomfort of uncertainty. And so I do think we need really good ideas for how best to do that because we all deserve to hopefully not be as unprepared as I worry, we are at the moment. Well, speaking of good ideas, one of the many hats that you wear is also as an investor and we're actually co invested in a company called Summer Health uh in the pediatric Space. And you've also invested in women's health, which is an area that I'm also very passionate about. Can you talk about the role of technology and innovation in these topics specifically around maternal health where this country is in a maternal health crisis, particularly among uh underserved populations of black people. Absolutely. So I'm originally from the state of Arkansas which uh has the iom um kind of a place at the moment of having the worst maternal health outcomes in the country. Um Now, some of this is probably what you're all kind of thinking of lack of prenatal care, kind of insufficient access to not only prenatal care but maternal health care and um kind of post natal care. That's absolutely true. It also though is kind of a place where we see so many of our inequities uh coalescing in really tragic ways. So a rise of opioid use disorder deaths in expecting a new moms, a huge spike in death by suicide in expectant and new moms in Arkansas. Not surprisingly, the number one leading cause of those deaths by suicides are with a firearm. And so we do see in Arkansas kind of all of these painful um kind of intersections of the failure to adequately protect kind of public or patient health and particularly our most vulnerable are black and brown expected in new moms. And so, you know, something that I am a huge believer in and I'm so happy to be able to manifest that kind of belief, you know, as an investor and an advocate is in having more midwife centered and O B G Y N supported care. We have not only reams of data over the last years and decades, but arguably, you know, far longer of how important kind of midwife centered and empowered care is. And so I'm so proud to be able to partner with a company that we've invested in Medora to bring that first to New York City. And then hopefully, you know, more broadly across the city and around the country and know there are many people in this room, you know, who are similarly working to kind of provide more women, more kind of continuous kind of high quality kind of access to care while they're pregnant, while they're giving birth and postpartum, you know, up to a year or longer, depending on how long they're breastfeeding or what sort of support those new moms need. That's good for those moms. That's also, of course, good for us as a country, not only kind of on an ethical or moral basis, although I would posit that should be sufficient, but also certainly on an economic basis given we know how much lost productivity there is uh for mothers who are not sufficiently supported, kind of in being their full selves. Absolutely. And not to pull a Rihanna in case anyone was wondering, I'm also expecting a baby soon. So very much appreciate all the innovation you have. You are bedazzled. You can, you are be we're gonna turn it into the audience for one question. So I think we've got a paddle somewhere right there who she's going to call on someone for their, for? My favorite color is blue. Great. Thank you. Um My name is Raj A, I'm a, a past surgeon and I'm just starting a company in the obesity and metabolic health space. And um Chelsea, you, you paying something in me, you said the cost of the antiretrovirals went down from $10,000 to $60. We know the obesity crisis is massive by 2035 4 billion people in this country will be sorry in the world will be suffering from obesity. That's about half the population. It's due to cost $4.3 trillion right? Which is about 3% of the global GDP. We've tried exercise lifestyle, let's move sugar taxes, all this kind of stuff. Medications are really taking a hit now. So how do you think we um manage this global crisis? Yeah, I think um such an important question and I think too, um, this is a question that affects not only those of us in this room. But, but more broadly, I mean, you know, for close to a decade now, uh the Joint Chiefs of staff have said that obesity, uh the obesity crisis in our country is a national security issue. You know, we have many um local fire departments and police departments that are not able to recruit kind of sufficient numbers because of a lack of kind of overall kind of health and fitness levels, you mentioned kind of the coming cost, but we, we see very much those costs here today already, not only kind of health care costs but also in loss of productivity. Um I would though, uh respectfully take a slight um kind of contention though, with you said, we've tried a lot of things. We haven't really tried any of those things at scale and in coordination and fewer than 10% of American kids in public elementary and middle schools have daily pe classes. We actually, we're talking about public private partnerships. If this is something that you all care about, put pressure on your kind of uh local school boards and depending on kind of what school district you live in and where the sources of funds are coming, kind of on your city council, on your state governments that they're title one schools and what the federal government is specifically allocating funds for. Then we tried sugar taxes. We haven't really, I mean, like Philadelphia is the only major city in our country that has a real soda tax. Um I know there is a big movement to try to put pressure on E BT and snap benefits. I don't support that because I'm deeply uncomfortable with telling people already living on the margins that um they should not have access to kind of the full choices of people not living on the margins. But I do think there needs to be a more concerted effort to try all of this in concert for kids, adolescents, you know, young adults and adults and you would know better than I, we also know different interventions are more likely to work um with greater effectiveness in those areas. And also absolutely. Um we need to be looking globally in the same way we did and continue to do with our market shaping work on kind of what will the generic sorry to the pharma companies in the room? But like what are the generic versions? What are the input costs? How quickly can this be manufactured? Can those be manufactured in a globally um purposely globally diverse way in the way that we've seen with antiretrovirals? Um antibiotics and increasingly vaccines can be manufactured in Latin America, in Asia, in South Africa, and East Africa, in West Africa, in Eastern Europe, you know, and elsewhere. Um And then how do we build on the pre-existing supply chains um to help ensure that the people who could benefit from, from medicines as part of a larger set of interventions have access to them. And of course, then having enough health care professionals who actually are there to deliver those and then assess the ongoing impact. And now Dana is cutting me off. I'm getting all right. Well, thank you so much Chelsea. There's so much more we could talk about, but really thanks to everyone. Thank you. Thank you.

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